Individual
SHAUNA LYNN DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
5321 BEVERLY PARK CIR, KNOXVILLE, TN 37918-9253
(865) 687-1321
Mailing address
155 RACCOON VALLEY RD, MAYNARDVILLE, TN 37807-3144
(865) 200-6372
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
0000005604
TN
Other
Enumeration date
01/09/2019
Last updated
01/09/2019
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