Individual
SHAWNTESSA MARIE DEJESUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
500 HIOAKS RD, RICHMOND, VA 23225-4061
(804) 560-6500
Mailing address
500 HIOAKS RD, RICHMOND, VA 23225-4061
(804) 560-6500
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126001239
VA
Other
Enumeration date
01/30/2008
Last updated
01/30/2008
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