Individual
SHANNON MACMINN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS OTR/L
Contact information
Practice address
134 INFIELD CT, MOORESVILLE, NC 28117-8026
(704) 799-6824
(704) 799-6825
Mailing address
8919 PARK RD, CHARLOTTE, NC 28210-9600
(704) 551-6800
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
8929
NC
Other
Enumeration date
10/14/2013
Last updated
04/14/2014
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