Individual
SHANNON LAING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1909 N HIGHWAY 17 STE Q, MT PLEASANT, SC 29464-7460
(843) 416-9026
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4990
(630) 296-2222
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2094
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2094
PT LICENSE #
SC
01
—
861168971
EMPLOYER ID#
SC
Enumeration date
03/08/2006
Last updated
07/21/2022
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