Individual
MICHAEL E SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7928 BROWN MOUNTAIN RD, JEWELL RIDGE, VA 24622-8640
(276) 881-8875
(276) 881-8875
Mailing address
7928 BROWN MOUNTAIN RD, JEWELL RIDGE, VA 24622-8640
(276) 881-8875
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
—
—
Other
Enumeration date
02/17/2020
Last updated
02/17/2020
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