Individual
MRS. MEREDITH LUCAS SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20589 W WALTON DR, BUCKEYE, AZ 85396-3532
(623) 243-3183
Mailing address
20589 W WALTON DR, BUCKEYE, AZ 85396-3532
(623) 243-3183
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4234
AZ
Other
Enumeration date
08/17/2010
Last updated
08/17/2010
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