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Individual

MS. SHANTELLE A WEICHERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC, CSCS

Contact information

Practice address
1731 W RIDGEWAY AVE, STE 600, WATERLOO, IA 50701-4595
(319) 833-5900
(319) 833-5901
Mailing address
5426 CAREY DR, CEDAR FALLS, IA 50613-7039
(319) 239-2738
(319) 268-0321

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
00201
IA

Other

Enumeration date
07/09/2006
Last updated
07/08/2007
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