Individual
ABBY SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5535 S WILLIAMSON BLVD, SUITE 774, PORT ORANGE, FL 32128-8311
(800) 330-7711
Mailing address
1005 WOODLOT RD, MANHEIM, PA 17545-9733
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119005772
VA
Other
Enumeration date
11/16/2012
Last updated
11/16/2012
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