Individual
SHANNON DALE COFFMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
808 BROWN RD, MADISONVILLE, KY 42431-2212
(270) 871-3122
Mailing address
808 BROWN RD, MADISONVILLE, KY 42431-2212
(270) 871-3122
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A01656
KY
Other
Enumeration date
05/17/2013
Last updated
05/17/2013
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