Individual
MRS. SHANNON WEIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
24422 AVENIDA DE LA CARLOTA STE 100, LAGUNA HILLS, CA 92653-3648
(949) 716-2730
Mailing address
24422 AVENIDA DE LA CARLOTA STE 100, LAGUNA HILLS, CA 92653-3648
(949) 716-2730
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
6369
CA
Other
Enumeration date
12/18/2023
Last updated
12/18/2023
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