Individual
DEVON THOMAS SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1968 HAWKS LN NE, BROOKHAVEN, GA 30329-2283
(513) 508-9717
Mailing address
1968 HAWKS LN NE, BROOKHAVEN, GA 30329-2283
(513) 508-9717
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
103696
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/13/2021
Last updated
07/16/2025
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