Individual
MRS. BROOKE SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2222 SULLIVAN TRL, EASTON, PA 18040-7958
(610) 991-2034
Mailing address
3879 BILL JONES RD, APISON, TN 37302-9749
(423) 322-5487
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
OTA0000001752
TN
Other
Enumeration date
02/15/2015
Last updated
02/15/2015
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