Individual
SHANNON VAVALLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, CES, OTC
Contact information
Practice address
4433 VESTAL PKWY E, VESTAL, NY 13850-3556
(607) 771-2220
(607) 251-2635
Mailing address
4433 VESTAL PKWY E, VESTAL, NY 13850-3556
(607) 771-2220
(607) 251-2635
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
020802088
NY
Other
Enumeration date
01/22/2024
Last updated
01/22/2024
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