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Shane Champion
NPI 1497033187 · on the registry since 2011 · sole proprietor
Practice
- Address
- 5500 Dara Ln
Grand Bay, AL 36541 - Phone
- (251) 454-1897
Registry record
- Primary taxonomy
- 225200000X
225200000X
- Licence states on file
- MS
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2011-07-28
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 Alabama