Individual
MR. SHANNON MICHAEL CHILDS I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, ATC
Contact information
Practice address
1090 IMESON RD, MCKINLEYVILLE, CA 95519-3424
(707) 826-4106
(707) 826-5446
Mailing address
1090 IMESON RD, MCKINLEYVILLE, CA 95519-3424
(707) 826-4106
(707) 826-5446
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/27/2006
Last updated
07/08/2007
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