Individual
SHANNON WYNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
2820 W CHARLESTON BLVD STE 1, LAS VEGAS, NV 89102-1942
(725) 726-7847
(725) 726-7876
Mailing address
9500 W MAULE AVE UNIT 2029, LAS VEGAS, NV 89148-4279
(702) 556-1163
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4642
NV
Other
Enumeration date
08/23/2021
Last updated
05/18/2022
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