Individual
SHAUN RICHARD SKAVANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1000 E UNIVERSITY AVE DEPT 3414, LARAMIE, WY 82071-2000
(605) 645-0417
Mailing address
1000 E UNIVERSITY AVE DEPT 3414, LARAMIE, WY 82071-2000
(605) 645-0417
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
060
WY
Other
Enumeration date
01/09/2012
Last updated
01/09/2012
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