Individual
MR. SHANNON DEWAYNE ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
86892 HIGHWAY 9, LINEVILLE, AL 36266-6949
(256) 396-9307
Mailing address
915 BELLS MILL RD, HEFLIN, AL 36264-2100
(256) 463-2334
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH1173
AL
Other
Enumeration date
04/12/2007
Last updated
07/08/2007
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