Individual
KENDRA SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1000 E MOUNTAIN DR, WILKES BARRE, PA 18711-0001
(570) 808-7300
Mailing address
637 CORNFIELD WAY APT 303, DALLAS, PA 18612-7235
(330) 608-3220
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA063023
PA
Other
Enumeration date
10/04/2021
Last updated
10/04/2021
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