Individual
RICHARD SCOTT SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1830 NW 122ND TER, PEMBROKE PINES, FL 33026-1966
(954) 435-5300
Mailing address
3672 SW 61ST AVE APT 1, DAVIE, FL 33314-2553
(954) 873-8673
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 20061
FL
Other
Enumeration date
03/15/2007
Last updated
07/08/2007
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