Individual
KAREN ANNE SHATTUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA, LMT
Contact information
Practice address
2 ENTERPRISE AVE NE STE C1, ISANTI, MN 55040-6811
(206) 471-2177
Mailing address
1808 JEFFERSON ST S, CAMBRIDGE, MN 55008-9358
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
A405
MN
225200000X
Physical Therapy Assistant
P160334491
WA
225700000X
Massage Therapist
Primary
MA60587436
WA
225700000X
Massage Therapist
MT.0008870
CO
Other
Enumeration date
05/18/2009
Last updated
03/17/2018
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