Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NP0017X | Pediatric Chiropractor | 14143 | TX |
NPI | 1093303406 |
---|---|
Provider Name | Brittany Shannon |
First Address | The Woodlands, TX 77382-1388 |
Second Address | Spring, TX 77380-1965 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2021 |
Last Update Date | 02/01/2021 |