Individual
SHANNON DAVID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AT
Contact information
Practice address
1301 CENTENNIAL BLVD BBFH # 1, FARGO, ND 58108-6050
(701) 231-5686
Mailing address
PO BOX 6050, FARGO, ND 58108-6050
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
05/08/2014
Last updated
05/08/2014
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