Individual
SHANE SCOTT URBAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
444 N. WESTHILL BLVD., APPLETON, WI 54914
(920) 750-7008
Mailing address
316 W 15TH AVE, OSHKOSH, WI 54902-6516
(920) 573-4028
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
127558-121
WI
Other
Enumeration date
03/18/2015
Last updated
03/18/2015
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