Individual
DR. KENNETH STEVEN SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
997 WINDMILL PKWY, EVANS, GA 30809-6666
(706) 787-7155
(706) 787-2666
Mailing address
997 WINDMILL PKWY, EVANS, GA 30809-6666
(706) 787-7155
(706) 787-2666
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1483
TN
Other
Enumeration date
12/05/2006
Last updated
07/08/2007
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