Individual
MRS. KELLY SHANER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
11 N BROAD ST, SALEM, VA 24153-3735
(540) 389-6305
Mailing address
11 N BROAD ST, SALEM, VA 24153-3735
(540) 389-6305
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305005453
VA
Other
Enumeration date
10/03/2017
Last updated
10/03/2017
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