Individual
SHANNON ROSE NEALON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
2953 S 168TH ST, SUITE 100, OMAHA, NE 68130-2000
(402) 593-7345
(402) 593-0882
Mailing address
2403 S 133RD PLZ, OMAHA, NE 68144-5905
(402) 330-8433
(402) 330-8616
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2534
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00453826
MEDIARE RR
NE
Enumeration date
02/27/2007
Last updated
04/02/2008
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