Individual
KEVIN SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
3101 37TH AVE N, SUITE A, ST PETERSBURG, FL 33713-1509
(727) 328-0599
Mailing address
4207 S DALE MABRY HWY, #1109, TAMPA, FL 33611-1423
(727) 776-4181
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT10326
FL
Other
Enumeration date
03/13/2008
Last updated
03/13/2008
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