Individual
SHANE CONDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4469 PEBBLE BEACH DR, OCEANSIDE, CA 92057-5008
(760) 716-9040
Mailing address
4469 PEBBLE BEACH DR, OCEANSIDE, CA 92057-5008
(760) 716-9040
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
04/05/2023
Last updated
04/05/2023
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