Individual
JESSAMYN SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA,
Contact information
Practice address
2250 E FLAMINGO RD, LAS VEGAS, NV 89119-5170
(702) 784-4303
Mailing address
6717 CHAMBERS LAKE CT, NORTH LAS VEGAS, NV 89084-2384
(760) 409-9684
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A-0669
NV
225200000X
Physical Therapy Assistant
AT 8021
CA
Other
Enumeration date
05/08/2007
Last updated
04/16/2015
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