Individual
SHANNON MARIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA, BS
Contact information
Practice address
2304 DUBOIS DR, WARSAW, IN 46580-3213
(574) 267-3500
Mailing address
2304 DUBOIS DR, WARSAW, IN 46580-3213
(574) 267-3500
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06005493A
IN
Other
Enumeration date
07/24/2017
Last updated
07/24/2017
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