Balthazr, Shannon Rae

Balthazr, Shannon Rae is an sole proprietor health care provider with primary practice located at 1 Medical Park Blvd , Bristol TN 37620-7430. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as her primary health care specialty. Balthazr, Shannon Rae can be contacted via phone (423) 844-4104.

Contact Information

Primary practice address
1 Medical Park Blvd Bristol TN 37620-7430
Phone: (423) 844-4104
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X 3766 Tennessee

Profile Details

NPI number 1891869186
LBN Legal business name Balthazr, Shannon Rae
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 20th, 2006
Last updated Jul 8th, 2007 - about 18 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.

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