Individual provider · NPI-1

Shannon David, AT

Specialist/Technologist, Athletic Trainer · Fargo, ND

NPI number1003227380
StatusActive
Last updated in NPPESMay 8, 2014

Details

NPI
1003227380
Entity type
Individual (NPI-1)
Name
Shannon David
Credential
AT
Sex
Female
Sole proprietor
Yes
Enumeration date
May 8, 2014
Last updated
May 8, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2255A2300X Specialist/Technologist, Athletic Trainer––Yes

Practice location

1301 Centennial Blvd Bbfh # 1
Fargo, ND 58108-6050

Phone 701-231-5686

Mailing address

Po Box 6050
Fargo, ND 58108-6050

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