Individual
SHANNON L HARMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
900 E BROADWAY AVE, BISMARCK, ND 58501-4520
(701) 530-8833
Mailing address
900 E BROADWAY AVE, P.O. BOX 5510, BISMARCK, ND 58506-5510
(701) 530-8833
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1099
SD
225100000X
Physical Therapist
Primary
1126
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1099
LICENSE
SD
01
—
1126
LICENSE
ND
Enumeration date
03/17/2008
Last updated
03/17/2008
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