Organization
FUNWORKS PEDIATRIC THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWNA LEA MCCORMICK PT (OWNER/ PHYSICAL THERAPIST)
(910) 689-5071
Entity
Organization
Contact information
Practice address
408 WASHINGTON ST, SOUTH POINT, OH 45680-9660
(910) 689-5071
(888) 398-8146
Mailing address
PO BOX 22, MINFORD, OH 45653-0022
(910) 689-5071
(888) 398-8146
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
003960
KY
Other
Enumeration date
06/22/2016
Last updated
06/19/2020
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