Individual
SHANNON LANCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
3900 N MINGO RD, TULSA, OK 74116-5000
(918) 292-3397
Mailing address
1341 E 146TH PL S, GLENPOOL, OK 74033-3714
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
775
OK
Other
Enumeration date
03/27/2015
Last updated
03/27/2015
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