MR. Shannon Wilcken, PTA

NPI #1467681304 in Venice, Florida

Provider Information

NPI Number: 1467681304
Entity Type: Individual
Name: MR. Shannon Wilcken, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Jul 14, 2009
Last Updated: Jul 14, 2009

Practice Location

Address: 3849 WOODMERE PARK BLVD APT 6
City: Venice
State: Florida
ZIP Code: 34293-5285
Phone: (863) 214-4333

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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