Individual
SHANNON M SOARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
228 EVERETT DR, SNEADS FERRY, NC 28460-8528
(774) 487-6450
Mailing address
228 EVERETT DR, SNEADS FERRY, NC 28460-8528
(774) 487-6450
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
LAT-4090
NC
Other
Enumeration date
05/06/2020
Last updated
05/06/2020
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