Individual
SHANNON DAWN HESTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
660 S 11TH ST, INDIANA, PA 17705
(717) 991-3283
Mailing address
100 GROVE LN APT 813, INDIANA, PA 15701-2128
(717) 991-3283
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
RT007852
PA
Other
Enumeration date
06/06/2022
Last updated
06/07/2022
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