Individual
SHANNON BASHOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
907 W SCHWAGER DR, WHITEWATER, WI 53190
(262) 472-1581
Mailing address
227 LARKSPUR CT, SUN PRAIRIE, WI 53590-3472
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2007-39
WI
Other
Enumeration date
04/02/2018
Last updated
04/02/2018
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