Individual
SHAWNA MAE CHARLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
56 MARKET ST, POTSDAM, NY 13676-1747
(315) 265-4065
Mailing address
1859 FORD ST, OGDENSBURG, NY 13669-1845
(315) 323-3913
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
007261
NY
Other
Enumeration date
10/21/2015
Last updated
10/21/2015
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