Individual
SHANNON D LAIRD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
212 CARTER DR, SUITE C, MIDDLETOWN, DE 19709-5837
(302) 378-7174
(302) 378-7157
Mailing address
212 CARTER DR, SUITE C, MIDDLETOWN, DE 19709-5837
(302) 378-7174
(302) 378-7157
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
J1-0001678
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000030585
—
DE
Enumeration date
08/20/2006
Last updated
07/09/2007
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