Individual
MATHEW SHANKWEILER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
30 WESTERN AVE, EAST MILLINOCKET, ME 04430-1040
(727) 249-3307
Mailing address
499 53RD AVE N, ST PETERSBURG, FL 33703-2960
(727) 249-3307
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
10/22/2018
Last updated
10/22/2018
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