Individual
DR. SHANNON MACNAB
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
518 S TAYLOR DR, SHEBOYGAN, WI 53081-4253
(920) 458-5757
Mailing address
1028 LOS ANGELES AVE, SHEBOYGAN, WI 53083-4841
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2664
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38597600
—
WI
Enumeration date
05/17/2006
Last updated
07/08/2007
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