Individual
MICHAEL SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2300 53RD AVE, BETTENDORF, IA 52722-7547
(563) 332-4422
Mailing address
2219 WEST 57TH, DAVENPORT, IA 52804
(563) 528-3110
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
01090
IA
Other
Enumeration date
02/22/2007
Last updated
07/08/2007
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