Individual
SUSANNA SHIVERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
120 WHITFORD DR, DURHAM, NC 27708-9982
(919) 668-5771
Mailing address
4025 FORRESTDALE DR, DURHAM, NC 27712-2981
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
09/07/2017
Last updated
09/07/2017
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