Individual
SHANAAZ KHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
610 S AVALON ST, WEST MEMPHIS, AR 72301-4109
(870) 400-3481
Mailing address
9205 SPEERBERRY CIR, CORDOVA, TN 38016-2399
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR1369
AR
Other
Enumeration date
06/13/2007
Last updated
07/08/2007
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