Individual
MRS. SHANNON COOPER MCMAHON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
100 E FLORIDA AVE, MELBOURNE, FL 32901-8302
(321) 727-0793
Mailing address
2804 MADERIA CIR, MELBOURNE, FL 32935-5595
(321) 242-2501
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL304
FL
Other
Enumeration date
05/21/2007
Last updated
07/08/2007
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