Individual
TOM SHAFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
1107 MEADOW CREST LN, MANSFIELD, TX 76063-2969
(575) 302-6375
Mailing address
1107 MEADOW CREST LN, MANSFIELD, TX 76063-2969
(575) 302-6375
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
118208
TX
Other
Enumeration date
12/18/2019
Last updated
12/18/2019
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