Individual
MRS. SHANNON M. HAUSCHILDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1155 W. PARKVIEW ST., SUITE 2 D, BOLIVAR, MO 65613-7800
(417) 777-2663
(417) 777-2666
Mailing address
1155 W. PARKVIEW ST., SUITE 2 D, BOLIVAR, MO 65613-7800
(417) 777-2663
(417) 777-2666
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
2004003730
MO
Other
Enumeration date
11/30/2005
Last updated
03/18/2014
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