Individual
SHANNON REX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
46 NORTH ST, HYANNIS, MA 02601-3845
(508) 771-0006
Mailing address
25 HORATIO LN, CENTERVILLE, MA 02632-3269
(508) 360-1924
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/19/2018
Last updated
09/19/2018
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