Individual
JANSEN SHEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
PO BOX 6000, BINGHAMTON, NY 13902-6000
(231) 342-4714
Mailing address
BINGHAMTON UNIVERSITY, EVENTS CENTER- PO BOX 6000, BINGHAMTON, NY 13902
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
003490
NY
Other
Enumeration date
11/08/2017
Last updated
11/08/2017
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