Individual
SHANNON MELISSA NORRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
723 S INTERSTATE 35 E, DENTON, TX 76205-4101
(800) 340-4098
(817) 789-6849
Mailing address
5316 TRAIL LAKE DR, FORT WORTH, TX 76133-1931
(817) 292-8787
(817) 789-6849
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2057018
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149984001
—
TX
05
—
207164901
—
TX
Enumeration date
08/31/2012
Last updated
08/31/2012
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