NPI 1144427329

Shannon Jackson, REHABTECH

Practitioner Other Technician South Bend, IN

Practice location

Address: 1950 Ridgedale Rd, South Bend, IN 46614-2243
Phone: (574) 291-6722
Mailing address: 507 E Broadway St, South Bend, IN 46601-3503

Registered specialties

Other Technician Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 247200000X

Other Technician, Other providers in Indiana →

Registry record

NPI: 1144427329
Entity type: Individual
Sex (as registered): Female
NPI issued: 29 Jun 2007
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.