Individual
SHANNON LEE BAIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
605 MAIN ST, HACKENSACK, NJ 07601-5914
(201) 488-0488
Mailing address
239 BROWN AVE, PROSPECT PARK, NJ 07508-1842
(973) 557-5790
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
40QA01570100
NJ
Other
Enumeration date
09/03/2014
Last updated
03/21/2018
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