Most Relevant Information
Provider Data
| NPI Number: | 1003452095 |
| Provider Name: | SHAY N FARRIS PTA |
| Entity Type: | Individual |
| Taxonomy Code: | 208100000X |
| Specialty: | Physical Medicine & Rehabilitation |
| License Number: | 160.004069 |
Most Important Dates
| Enumeration Date: | 11/25/2019 |
| Last Updated: | 11/25/2019 |
Provider Practice Location
800 E LOCUST ST
OLNEY
IL
624502553
Practice Location Phone/Fax
| Phone: | 6183956031 |
| Fax: |
Provider Mailing Location
800 E LOCUST ST
OLNEY
IL
624502553
Provider Mailing Phone/Fax
| Phone: | 6183956031 |
| Fax: |