Individual
MR. JOHN ANDREW PATRICK SHAGREN II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
2801 WALNUT HILL ST, APT 5B, PHILADELPHIA, PA 19152-1549
(267) 343-8695
Mailing address
2801 WALNUT HILL ST, APT 5B, PHILADELPHIA, PA 19152-1549
(267) 343-8695
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN059758L
PA
Other
Enumeration date
04/26/2007
Last updated
07/08/2007
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