Individual
MISS SHANNON LEAH HATTERVIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1100 NORTH AVE, GRAND JUNCTION, CO 81501-3122
(970) 248-1985
Mailing address
552 GUNNISON AVE APT 3, GRAND JUNCTION, CO 81501-4801
(605) 391-6713
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-1004
CO
Other
Enumeration date
01/26/2012
Last updated
05/01/2014
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