Provider Demographics
NPI:1942281555
Name:MARSHALL, SHANNON M (PT)
Entity Type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:M
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3277 S LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2512
Mailing Address - Country:US
Mailing Address - Phone:720-274-0341
Mailing Address - Fax:303-388-8990
Practice Address - Street 1:7821 W 38TH AVE STE 101
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-6185
Practice Address - Country:US
Practice Address - Phone:303-330-0010
Practice Address - Fax:303-388-8990
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0008132225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist