Shane Mccormick, OTR/L

NPI 1295071611 · on the registry since 2012

Practice

Address: 310 E Broadway Ave
Jackson, WY 83001
Phone: (307) 734-2877
Fax: (307) 734-2827
Organisation at this address: Orthopedic Sports Trauma Llc
Jackson Hole Mental Health Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 28

Registry record

Primary taxonomy: 225X00000X
225X00000X
Licence states on file: WY
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2020-07-01

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wyoming