Individual
KEVIN SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2575 PEACHTREE PKWY, CUMMING, GA 30041-7559
(678) 679-6400
Mailing address
PO BOX 724557, ATLANTA, GA 31139-1557
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
07/06/2018
Last updated
07/06/2018
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