Individual
DUJUAN SHAKESPAERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS,ATC,LAT
Contact information
Practice address
652 S MEDICAL CTR DR, ST GEORGE, UT 84790-7017
(435) 251-2286
Mailing address
2568 E 160 S, ST GEORGE, UT 84790-6559
(818) 300-5661
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
7468860-4810
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000002230
NATIONAL ATHLETIC TRAINERS' ASSOCIATION BOARD OF CERTIFICATION
—
Enumeration date
11/30/2011
Last updated
11/30/2011
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