Individual
SUSAN SHANKS WEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2971 FORT HENRY DR, KINGSPORT, TN 37664-4005
(423) 230-8456
(423) 230-8496
Mailing address
116 LAZY LN, GRAY, TN 37615-4272
(423) 477-3090
(423) 477-4761
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
1163
TN
Other
Enumeration date
03/14/2007
Last updated
07/08/2007
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