Individual
SHANNON NEALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6600 EXCELSIOR BLVD, SUITE 160, ST LOUIS PARK, MN 55426-4744
(952) 993-7700
Mailing address
6465 WAYZATA BLVD, SUITE 315, ST LOUIS PARK, MN 55426-1728
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
44585
MN
Other
Enumeration date
12/29/2005
Last updated
10/06/2011
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