Individual
SHELBY NICOLE FANKHAUSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
4249 HIGHWAY 411, MADISONVILLE, TN 37354-1544
(423) 442-4034
(423) 442-6463
Mailing address
1200 CORPORATE DR STE 400, BIRMINGHAM, AL 35242-5424
(423) 238-7217
(423) 238-3473
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2112
TN
Other
Enumeration date
03/02/2018
Last updated
03/02/2018
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