Individual
CHAD SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1101 VETERANS DR, LEXINGTON, KY 40502-2235
(859) 233-4511
(859) 381-5994
Mailing address
1112 RICHMOND GREEN DR, APT 4, RICHMOND, KY 40475-6827
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
T07018
KY
Other
Enumeration date
06/06/2007
Last updated
07/08/2007
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