NPI 1295071611

Shane Kenneth McCormick, OTRL

Practitioner Occupational Therapist Jackson, WY

Practice location

Address: 310 E Broadway Ave, Jackson, WY 83001-8636
Phone: (307) 734-2877
Fax: (307) 734-2827
Mailing address: 555 Saint Josephs Blvd, Elmira, NY 14901-3223

Registered specialties

Occupational Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225X00000X Licence OT-1386 (WY)

Other Occupational Therapist providers in Wyoming →

Registry record

NPI: 1295071611
Entity type: Individual
Sex (as registered): Male
NPI issued: 13 Dec 2012
Record last updated: 1 Jul 2020

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.