Individual
JENNIFER STANSHAW-BASA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
5199 IVY ST, COMMERCE CITY, CO 80022-4404
(800) 289-3595
Mailing address
5080 SPECTRUM DR STE 1200W, ADDISON, TX 75001-4624
(469) 261-4337
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000000185
CA
Other
Enumeration date
08/16/2021
Last updated
08/16/2021
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