Individual
SHANNON EATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9768 LIBERTY DR, PAINTED POST, NY 14870-9094
(607) 382-6104
Mailing address
6205 STEWART RD, BATH, NY 14810-8227
(607) 382-6104
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
044698
NY
Other
Enumeration date
12/02/2019
Last updated
03/08/2021
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