Individual
DANA SHACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
3400 CORAL WAY STE 202, MIAMI, FL 33145-3053
(305) 856-1999
Mailing address
5299 HAMMOCK DR, CORAL GABLES, FL 33156-2101
(786) 351-2766
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT36046
FL
Other
Enumeration date
06/07/2021
Last updated
06/07/2021
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