MR. Shane Kenneth Mccormick, OTR/L

NPI #1295071611 in Jackson, Wyoming

Provider Information

NPI Number: 1295071611
Entity Type: Individual
Name: MR. Shane Kenneth Mccormick, OTR/L
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Occupational Therapist
Credential: OTR/L
Enumeration Date: Dec 13, 2012
Last Updated: Jul 1, 2020

Practice Location

Address: 310 E BROADWAY AVE
City: Jackson
State: Wyoming
ZIP Code: 83001-8636
Phone: (307) 734-2877

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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