Shannon Mcivor

NPI #1598075426 in Ward, Arkansas

Provider Information

NPI Number: 1598075426
Entity Type: Individual
Name: Shannon Mcivor
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapist
Enumeration Date: Oct 13, 2010
Last Updated: Oct 13, 2010

Practice Location

Address: 1500 WILSON LOOP
City: Ward
State: Arkansas
ZIP Code: 72176
Phone: (501) 941-5630

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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