Individual
SHANNON MARIE DICIANNO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
3100 MARKET ST, SAINT LOUIS, MO 63103-2528
(314) 421-2557
Mailing address
303 ERNEST PL, O FALLON, MO 63366-2908
(775) 219-3633
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2023046581
MO
Other
Enumeration date
11/22/2023
Last updated
11/22/2023
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