Individual
MRS. SHANNON MICHELLE MARTYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
2300 CHARLES ST, SUITE C, FREDERICKSBURG, VA 22401-3346
(540) 368-1400
Mailing address
8710 GLADEWATER CT, RICHMOND, VA 23294-6043
(804) 319-6582
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
2305204797
VA
Other
Enumeration date
10/10/2006
Last updated
07/08/2007
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