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Individual

SHANNON INTREPIDI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
419 CHIPPEWA ST, MINOCQUA, WI 54548
(715) 356-5733
(715) 356-5733
Mailing address
PO BOX 182, MINOCQUA, WI 54548-0182
(715) 356-5733
(715) 356-5733

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary

Other

Enumeration date
02/03/2014
Last updated
02/03/2014
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