Individual
SHANNON CONN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6464 DILLON DR UNIT 3, PUEBLO, CO 81008-1956
(605) 216-6753
Mailing address
6464 DILLON DR UNIT 3, PUEBLO, CO 81008-1956
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3417
CO
Other
Enumeration date
07/29/2015
Last updated
07/29/2015
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