Individual
JOHN DYLAN SHAPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
810 E 23RD ST, SIOUX FALLS, SD 57105-2135
(605) 977-6845
Mailing address
810 E 23RD ST, SIOUX FALLS, SD 57105-2135
(605) 977-6845
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0601
SD
Other
Enumeration date
12/12/2019
Last updated
12/12/2019
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