Individual
SHANNON NICOLE BARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
W4070 DEVINE LN, APPLETON, WI 54913-8399
(920) 422-2016
Mailing address
W4070 DEVINE LN, APPLETON, WI 54913-8399
(920) 422-2016
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2762-19
WI
Other
Enumeration date
02/18/2019
Last updated
02/18/2019
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