Individual
MR. JOHN MONTGOMERY SHIELDS II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPTA
Contact information
Practice address
116 LANE DR, TRINITY, NC 27370-9343
(336) 434-1706
Mailing address
714 4TH ST, SPENCER, NC 28159-1622
(704) 212-8013
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1600
NC
Other
Enumeration date
11/19/2012
Last updated
11/19/2012
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