Provider Demographics
NPI:1396049995
Name:CAIN, SHANNON KATHLEEN (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:KATHLEEN
Last Name:CAIN
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:SHANNON
Other - Middle Name:KATHLEEN
Other - Last Name:GORDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, OTR/L
Mailing Address - Street 1:2400 WILDWOOD RD
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044
Mailing Address - Country:US
Mailing Address - Phone:412-487-7771
Mailing Address - Fax:412-487-7772
Practice Address - Street 1:2400 WILDWOOD RD
Practice Address - Street 2:
Practice Address - City:GIBSONIA
Practice Address - State:PA
Practice Address - Zip Code:15044
Practice Address - Country:US
Practice Address - Phone:412-487-7771
Practice Address - Fax:412-487-7772
Is Sole Proprietor?:No
Enumeration Date:2010-12-23
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC011420208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation