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Shannon Clinic
Prosthetic/Orthotic Supplier in San Angelo, Texas
NPI 1356752307

Shannon Clinic is a Prosthetic/Orthotic Supplier based in San Angelo, TX. Shannon Clinic practices in San Angelo, TX. The NPI Number for Shannon Clinic is 1356752307 and holds a License No. 1210 (Texas).

The current practice location address for Shannon Clinic is 110 E Twohig Ave, San Angelo, TX and can be reached out via phone at 325-658-1511 and via fax at 325-481-2166.

Location: 110 E Twohig Ave, San Angelo, TX, 76902-7200
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1356752307
Provider Name
Shannon Clinic
Credential
Provider Entity Type
Organization
Address
110 E Twohig Ave, San Angelo, TX, 76902-7200
Phone Number
325-658-1511
Fax Number
325-481-2166
Provider Enumeration Date
05/13/2014
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
CPED4075 01 TX CERTIFICATION
institution
Provider Business Practice Location Address Details
Address
110 E Twohig Ave
City
San Angelo
State
Texas
Zip
76903-5916
Phone Number
325-658-1511
Fax Number
325-481-2166
person
Provider Business Mailing Address Details
Address
110 E Twohig Ave
City
San Angelo
State
Texas
Zip
76903-5916
Phone Number
325-658-1511
Fax Number
325-481-2166
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
335E00000X
License No.
1210 (Texas)
Definition
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
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