Individual
MISS MEGAN RENAE SHIFFLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
875 PERIMETER DR # MS 2302, MOSCOW, ID 83844-2302
(208) 885-0256
(208) 885-0254
Mailing address
875 PERIMETER DR # MS 2302, MOSCOW, ID 83844-2302
(208) 885-0256
(208) 885-0254
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-348
ID
Other
Enumeration date
12/16/2014
Last updated
12/16/2014
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