Mark Shea

NPI #1932665403 in Prior Lake, Minnesota

Provider Information

NPI Number: 1932665403
Entity Type: Individual
Name: Mark Shea
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Driver
Enumeration Date: Feb 20, 2019
Last Updated: Feb 20, 2019

Practice Location

Address: 17242 HORIZON TRL SE
City: Prior Lake
State: Minnesota
ZIP Code: 55372-3939
Phone: (612) 380-8301

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Driver	172A00000X	Primary

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