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Individual

MR. SHANNON B. ERICSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MS, PT

Contact information

Practice address
5425 W 100TH TER, OVERLAND PARK, KS 66207-3119
(913) 825-6636
Mailing address
5425 W 100TH TER, OVERLAND PARK, KS 66207-3119
(913) 825-6636

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-01600
KS

Other

Enumeration date
04/12/2006
Last updated
07/19/2007
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