Individual
JESSICA SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
18466 KENYON AVE, LAKEVILLE, MN 55044-6911
(612) 470-3688
Mailing address
9620 LIVERY LN, LAKEVILLE, MN 55044-7128
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6503
MN
Other
Enumeration date
04/25/2018
Last updated
12/23/2022
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