Individual
SHANA MARIE STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3600 COMMERCE ST APT 105, DALLAS, TX 75226-1797
(618) 767-0652
Mailing address
3600 COMMERCE ST APT 105, DALLAS, TX 75226-1797
(618) 767-0652
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
09/13/2022
Last updated
09/13/2022
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