Anderson, Shannon Wallace
Anderson, Shannon Wallace is an individual health care provider with primary practice located at 2814 Gray Fox Rd , Monroe NC 28110-8422. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Anderson, Shannon Wallace can be contacted via phone (704) 821-0568.Contact Information
Primary practice address
2814 Gray Fox Rd
Monroe NC 28110-8422
Phone: (704) 821-0568
Fax: (704) 821-0570
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 11487 | North Carolina |
Profile Details
| NPI number | 1558588244 |
|---|---|
| LBN Legal business name | Anderson, Shannon Wallace |
| Credentials | PT, DPT |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 20th, 2007 |
| Last updated | Jun 13th, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558588244 | NPPES |
| North Carolina | MEDICAID | 7212458 |
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