| Doctor Name: | MR. SHANNON COLE WINN |
| NPI Number: | 1154338440 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CPO |
| License Number: | CPO02652 |
| Business Practice Address: | 1075 S Idaho Rd Suite 101 Apache Junction, AZ - 852196496 |
| Business Phone Number: | 4809823000 |
| Business Fax Number: | 4809823103 |
| Mailing Address: | 1075 S Idaho Rd, Suite 101 APACHE JUNCTION |
| State: | AZ |
| Postal Code: | 852196496 |
| Phone Number: | 4809823000 |
| Fax Number: | 4809823103 |
| NPI Enumeration Date: | 08/01/2006 |
| NPI Last Update Date: | 03/06/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1744P3200X |
| License Number: | CPO02652 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | Prosthetics Case Management |
| Taxonomy Definition: | |