Individual
SHANNON S LAGERAAEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13 GROVER LN, EAST NORTHPORT, NY 11731-3014
(631) 848-1403
Mailing address
13 GROVER LN, EAST NORTHPORT, NY 11731-3014
(631) 848-1403
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/08/2022
Last updated
06/08/2022
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