Individual
SHANNA NIJEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
6900 PECOS RD, NORTH LAS VEGAS, NV 89086-4400
(702) 791-9000
Mailing address
6128 DILLON FALLS CT, NORTH LAS VEGAS, NV 89031-3705
(706) 945-4828
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA002784
GA
Other
Enumeration date
05/04/2016
Last updated
05/04/2016
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