Individual
MISS SHANNA HAWKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
618 S MAIN ST, REIDSVILLE, NC 27320-5020
(336) 951-6090
Mailing address
1120 WINDING RIDGE RD, WALNUT COVE, NC 27052-6434
(336) 830-5061
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5615
NC
Other
Enumeration date
05/17/2015
Last updated
05/17/2015
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