Individual
MATTHEW PATRICK SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2680 S VAL VISTA DR STE 116, GILBERT, AZ 85295-2154
(480) 507-5678
(480) 507-5677
Mailing address
1356 W 14TH ST, TEMPE, AZ 85281-6407
(602) 505-2894
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6866
AZ
Other
Enumeration date
09/20/2017
Last updated
09/20/2017
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