Individual
AMY SHANK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18945 FM 2252, GARDEN RIDGE, TX 78266-2562
(210) 651-0027
Mailing address
26020 AVENIDA DEL ORO, TEMECULA, CA 92590-3977
(951) 506-3895
Taxonomy
Speciality
Code
Description
License number
State
286500000X
Military Hospital
Primary
572910
CA
Other
Enumeration date
04/09/2010
Last updated
04/09/2010
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