NPI 1871210039

Samuel C Shannon, PTA

Practitioner Physical Therapy Assistant Blythewood, SC

Practice location

Address: 420b McNulty St, Blythewood, SC 29016-8786
Phone: (803) 728-0421
Fax: (803) 728-0424

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence 4846 (SC)

Other Physical Therapy Assistant providers in South Carolina →

Registry record

NPI: 1871210039
Entity type: Individual
Sex (as registered): Male
NPI issued: 27 Oct 2022
Record last updated: 27 Oct 2022

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.