Individual
CORISSA DAWN SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
414 E 8TH AVE, HUTCHINSON, KS 67501-1426
(620) 663-5932
Mailing address
414 E 8TH AVE, HUTCHINSON, KS 67501-1426
(620) 663-5932
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1402891
KS
Other
Enumeration date
10/06/2015
Last updated
10/06/2015
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