Individual
KARRIE A SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
35000 KAISER CT, SUITE 301, WILLOUGHBY, OH 44094-3382
(440) 951-6677
Mailing address
1257 FOXFIRE DR, PAINESVILLE, OH 44077-5257
(440) 974-2250
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 009156
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2622755
—
OH
Enumeration date
07/13/2006
Last updated
07/08/2007
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