Individual
SHIANNA MARIE DUVALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
64 RIDGWAY DR, DALLAS, PA 18612-9263
(570) 255-4578
Mailing address
64 RIDGWAY DR, DALLAS, PA 18612-9263
(570) 255-4578
(570) 255-4575
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TE012824
PA
Other
Enumeration date
10/22/2024
Last updated
10/22/2024
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