Individual
SHANNON TISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5350 W NEW MARKET RD, HILLSBORO, OH 45133-7722
(937) 393-1904
(937) 393-0496
Mailing address
5350 W NEW MARKET RD, HILLSBORO, OH 45133-7722
(937) 393-1904
(937) 393-0496
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT.0000994
OH
Other
Enumeration date
01/23/2014
Last updated
01/23/2014
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