Individual
SHANNON KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC, LMT
Contact information
Practice address
363 ROUTE 111, SUITE LL8, SMITHTOWN, NY 11787-4756
(631) 257-5757
(631) 419-8057
Mailing address
363 ROUTE 111, SUITE LL8, SMITHTOWN, NY 11787-4756
(631) 257-5757
(631) 419-8057
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
005430
NY
172M00000X
Mechanotherapist
025155-1
NY
Other
Enumeration date
01/26/2012
Last updated
08/03/2015
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