| Doctor Name: | SHANNON KELLIE PIETRAS |
| NPI Number: | 1851639298 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | PT3976 |
| Business Practice Address: | 2 Davis Point Ln Suite 1a Cape Elizabeth, ME - 041072620 |
| Business Phone Number: | 2077679773 |
| Business Fax Number: | 2075419212 |
| Mailing Address: | 2 Davis Point Ln, Suite 1a CAPE ELIZABETH |
| State: | ME |
| Postal Code: | 041072620 |
| Phone Number: | 2077679773 |
| Fax Number: | 2075419212 |
| NPI Enumeration Date: | 01/18/2013 |
| NPI Last Update Date: | 01/18/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251G0304X |
| License Number: | PT3976 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Geriatrics |
| Taxonomy Definition: | |