Individual
SHANA RANAE BARTELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1104 W MAIN ST, BENTON, IL 62812-1565
(618) 439-3399
(618) 439-4801
Mailing address
1001 W MAPLEWOOD ST, MARION, IL 62959-2045
(618) 993-1334
(618) 993-1334
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096-001537
IL
Other
Enumeration date
04/09/2006
Last updated
05/16/2016
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