Individual
JASON L SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
205 S COLLEGE AVE, MARIONVILLE, MO 65705-9340
(417) 463-7261
Mailing address
205 S COLLEGE AVE, MARIONVILLE, MO 65705-9340
(417) 463-7261
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
114021
MO
Other
Enumeration date
01/07/2009
Last updated
01/09/2009
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