Doctor Name: | SHANNON MCIVOR |
NPI Number: | 1598075426 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | PT3261 |
Business Practice Address: | 1500 Wilson Loop Ward, AR - 72176 |
Business Phone Number: | 5019415630 |
Business Fax Number: | |
Mailing Address: | 15351 Highway 5, Apt 227 CABOT |
State: | AR |
Postal Code: | 72023 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 10/13/2010 |
NPI Last Update Date: | 10/13/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT3261 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
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 |