Individual
SHAWN MICHAEL WYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
210 W WALNUT ST, CANTON, IL 61520
(309) 647-5240
Mailing address
210 W WALNUT ST, CANTON, IL 61520-2444
(309) 647-5240
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209.013769
IL
Other
Enumeration date
02/04/2016
Last updated
08/13/2018
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