Individual
SHANNON JEAN TETER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2020 QUAIL DR, INDEPENDENCE, MO 64057-3429
(816) 521-5480
Mailing address
201 N FOREST AVE, INDEPENDENCE, MO 64050-2696
(816) 521-5300
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
14-00285
MO
Other
Enumeration date
09/11/2024
Last updated
09/11/2024
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