Individual
MR. SHANNON OSBORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7500 SW 30TH ST, DAVIE, FL 33314-1020
(954) 452-7071
Mailing address
2501 SW 71ST TER, APT 101, DAVIE, FL 33317-7037
(334) 549-4765
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL4152
FL
Other
Enumeration date
07/18/2016
Last updated
07/18/2016
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