Individual
MR. ALAN SHAWN RIDENOURE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.ED., ATC/L, CSCS
Contact information
Practice address
1505 DAPHNE AVE, DAPHNE, AL 36526-4298
(251) 625-3176
(251) 625-3198
Mailing address
1319 CHAMBERLAIN AVE, MOBILE, AL 36604-2248
(251) 625-3178
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
165
AL
Other
Enumeration date
06/12/2006
Last updated
07/08/2007
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