Individual
MRS. SHANNON MARIE MCMANUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LD/N
Contact information
Practice address
3300 PUBLIX CORPORATE PKWY, LAKELAND, FL 33811-3311
(863) 688-1188
Mailing address
5868 HOLLYHOCK DR, LAKELAND, FL 33813-3274
(863) 619-8631
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND3623
FL
Other
Enumeration date
01/15/2013
Last updated
01/15/2013
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