NPI 1346463924

Shannon Marie Smith

Practitioner Rehabilitation Practitioner Wyoming, MN

Practice location

Address: 5200 Fairview Blvd, Wyoming, MN 55092-8013
Phone: (651) 982-7000
Mailing address: 8028 242nd Ave NE, Stacy, MN 55079-9310

Registered specialties

Rehabilitation Practitioner Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225400000X Licence 7892 (MN)

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Registry record

NPI: 1346463924
Entity type: Individual
Sex (as registered): Female
NPI issued: 11 Apr 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.