Individual
SHAWN GANLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
6305 118TH AVE, LARGO, FL 33773-3729
(727) 538-7410
Mailing address
6305 118TH AVE, LARGO, FL 33773-3729
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1384
FL
Other
Enumeration date
01/29/2018
Last updated
01/29/2018
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