Individual
TIFFANY SHADICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
835 PARKSIDE ST, RIPON, WI 54971-8505
(920) 748-1673
Mailing address
528 E JACKSON ST, RIPON, WI 54971-1353
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
02/12/2015
Last updated
02/13/2015
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