DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

KATIE J SHANNON, ATC/LAT

Active Sole Proprietor

KATIE J SHANNON, ATC/LAT is a Physical Medicine & Rehabilitation healthcare provider located in MOUNTAIN GROVE, Missouri. NPI 1619450244 is currently active in the NPPES registry. Verify at CMS.

Physical Medicine & Rehabilitation · MOUNTAIN GROVE, MO

Registration Details

NPI Number
1619450244
Provider Type
Individual
Gender
Female
NPI Issued
Sep 10, 2018 (7.9415097836617 yrs)
Last Updated
Sep 10, 2018
License
2018032324 (MO)
Sole Proprietor
Yes

Practice Information

Address
1206 N MAIN ST
MOUNTAIN GROVE, MO, 657111025
Browse MO providers · Browse ZIP 65711
Phone
4179265699
Primary Specialty
Physical Medicine & Rehabilitation
208100000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.