Individual
MRS. SHANNA MICHELE AUTREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
160 UNDERCLIFF TER, PRINCETON, WV 24740-2174
(304) 431-3010
(304) 431-3011
Mailing address
160 UNDERCLIFF TER, PRINCETON, WV 24740-2174
(304) 431-3010
(304) 431-3011
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
566
WV
Other
Enumeration date
11/29/2005
Last updated
05/04/2012
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