Individual
SHANNON B BERRIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
811 W MAIN ST STE 205, LEXINGTON, SC 29072-2500
(803) 358-6115
(803) 358-6117
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3916
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3916
LICENSE
SC
Enumeration date
02/08/2007
Last updated
10/13/2020
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