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Individual

SAMANTHA JO SHRUCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LAT, ATC

Contact information

Practice address
101 BRANIGIN BLVD, FRANKLIN, IN 46131-2598
(317) 738-8173
Mailing address
101 BRANIGIN BLVD, FRANKLIN, IN 46131-2598

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36002902A
IN

Other

Enumeration date
09/01/2017
Last updated
09/01/2017
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