Doctor Name: | SHANNON L. MCCORMICK |
NPI Number: | 1245461938 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 4053 |
Business Practice Address: | 770 Baconsfield Dr Macon, GA - 312111400 |
Business Phone Number: | 4788412772 |
Business Fax Number: | |
Mailing Address: | 110 Kells Ct, MACON |
State: | GA |
Postal Code: | 312104245 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 07/29/2009 |
NPI Last Update Date: | 07/29/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 4053 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |