Individual
JILLIAN SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
95 WASHINGTON ST, CANTON, MA 02021-4006
(781) 828-7951
Mailing address
592 GILBERT ST, BALDWIN, NY 11510-3822
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
035711
NY
225100000X
Physical Therapist
Primary
20321
MA
Other
Enumeration date
12/27/2012
Last updated
07/02/2019
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