Individual
JOHN RILEY SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
315 N LAKE RD, HOOVER, AL 35242-7015
(205) 908-5495
Mailing address
315 N LAKE RD, HOOVER, AL 35242-7015
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/14/2021
Last updated
01/14/2021
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