Individual
COLTON SHANK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3501 JOHNSON ST, HOLLYWOOD, FL 33021-5421
(954) 987-2000
Mailing address
21592 FM 1954, HOLLIDAY, TX 76366-3960
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
973026
TX
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/14/2025
Last updated
07/14/2025
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