Individual
SHAUN SHIELDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1814 N. BROAD STREET, PHILADELPHIA, PA 19121
(215) 204-2153
Mailing address
1305 WINCHESTER ST, BALTIMORE, MD 21217-2726
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/27/2020
Last updated
02/27/2020
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