Most Relevant Information
Provider Data
| NPI Number: | 1003572009 |
| Provider Name: | SHANNON MELLON DPT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/14/2021 |
| Last Updated: | 11/14/2021 |
Provider Practice Location
20 YORK ST
NEW HAVEN
CT
065103220
Practice Location Phone/Fax
| Phone: | 8603022686 |
| Fax: |
Provider Mailing Location
64 CHAPEL ST
BRISTOL
CT
060102310
Provider Mailing Phone/Fax
| Phone: | 8603022686 |
| Fax: |