Individual
MARY SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
5271 GETWELL RD, SOUTHAVEN, MS 38672-9608
(901) 337-1656
Mailing address
5271 GETWELL RD, SOUTHAVEN, MS 38672-9608
(901) 337-1656
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT6785
MS
Other
Enumeration date
08/07/2019
Last updated
03/10/2021
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