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Individual

SHAD MICHAEL ST. LOUIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS, OTR, CDRS

Contact information

Practice address
3425 S CLARKSON ST, ENGLEWOOD, CO 80113-2811
(303) 789-8218
Mailing address
1605 SAINT PAUL ST, #7, DENVER, CO 80206-1618
(720) 933-7228

Taxonomy

Speciality
Code
Description
License number
State
224ZR0403X
Driving and Community Mobility Occupational Therapy Assistant
1927
CO
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
1927
CO

Other

Enumeration date
02/09/2010
Last updated
02/09/2010
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