Individual
JESSICA SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
135 PLAZA DR STE 202, SIKESTON, MO 63801-5148
(573) 472-7134
Mailing address
1008 N MAIN ST, SIKESTON, MO 63801-5044
(573) 472-7423
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
2021030572
MO
Other
Enumeration date
08/02/2021
Last updated
06/26/2023
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