Individual
SHAWN EDWARD ROSTUCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3429 SALMON ST, PHILADELPHIA, PA 19134-6014
(267) 606-8886
Mailing address
3429 SALMON ST, PHILADELPHIA, PA 19134-6014
(267) 606-8886
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
32972995
PA
Other
Enumeration date
01/09/2024
Last updated
01/09/2024
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