Individual
SHANNON WAID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, CST
Contact information
Practice address
9020 58TH DR E STE 101, BRADENTON, FL 34202-6107
(941) 755-0406
Mailing address
135 166TH ST NE, BRADENTON, FL 34212-5605
(720) 325-8473
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
MA86132
FL
Other
Enumeration date
08/29/2019
Last updated
08/29/2019
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