Individual
MISS DEBORAH ANN FANNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
EMT, ATC
Contact information
Practice address
2820 HPER CTR, BROOKINGS, SD 57007-1497
(605) 688-4003
Mailing address
2820 HPER CTR, BROOKINGS, SD 57007-1497
(605) 688-4003
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0485
SD
Other
Enumeration date
07/13/2015
Last updated
07/13/2015
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