Mccormick, Shane Kenneth

Mccormick, Shane Kenneth is an individual health care provider with primary practice located at 310 E Broadway Ave , Jackson WY 83001-8636. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as his primary health care specialty. Mccormick, Shane Kenneth can be contacted via phone (307) 734-2877.

Contact Information

Primary practice address
310 E Broadway Ave Jackson WY 83001-8636
Phone: (307) 734-2877
Fax: (307) 734-2827
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X OT-1386 Wyoming

Profile Details

NPI number 1295071611
LBN Legal business name Mccormick, Shane Kenneth
Credentials OTR/L
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2012
Last updated Jul 1st, 2020 - about 5 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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