Individual
SHANE N ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
103 S PINE ST, PINEVILLE, KY 40977-1610
(606) 254-2075
Mailing address
103 S PINE ST, PINEVILLE, KY 40977-1610
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
007501
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1720589724
CHAMPION KY NPI
KY
Enumeration date
08/28/2018
Last updated
08/28/2018
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