Individual
MS. SHANNON MARIE LAFOUNTAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
8830 VIRGINIA ST, AMELIA COURT HOUSE, VA 23002-4826
(804) 561-1617
Mailing address
6065 OAK GROVE LOOP, AMELIA COURT HOUSE, VA 23002-3543
(804) 467-1971
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306001077
VA
Other
Enumeration date
10/31/2018
Last updated
10/31/2018
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