Individual
SHAUN WALDRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LMT
Contact information
Practice address
5496 E TAFT RD STE C, NORTH SYRACUSE, NY 13212-3784
(315) 251-3100
Mailing address
5496 E TAFT RD STE C, NORTH SYRACUSE, NY 13212-3784
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
001911
NY
225700000X
Massage Therapist
024785
NY
Other
Enumeration date
04/04/2011
Last updated
04/15/2016
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