Individual
MS. KELLY SHANER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
100 FALLWOOD RD, REDWOOD FALLS, MN 56283-1828
(507) 637-4500
Mailing address
23789 490TH AVE, SANBORN, MN 56083-4106
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2687
MN
Other
Enumeration date
10/29/2015
Last updated
10/29/2015
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