Individual
SHANE WINKENWADER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
628 23RD ST E APT B, WEST FARGO, ND 58078-2396
(701) 355-6483
Mailing address
628 23RD ST E APT B, WEST FARGO, ND 58078-2396
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
ND
Other
Enumeration date
06/04/2014
Last updated
06/04/2014
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