Individual
SHANNON NOWELLE MYERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4681 OSAGE BEACH PKWY, OSAGE BEACH, MO 65065-2069
(573) 302-4909
Mailing address
PO BOX 1265, LAKE OZARK, MO 65049-1265
(573) 280-0005
Taxonomy
Speciality
Code
Description
License number
State
224900000X
Mastectomy Fitter
Primary
C73524
MO
Other
Enumeration date
05/25/2026
Last updated
05/25/2026
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