John Dylan Shape
Specialist/Technologist, Athletic Trainer in Sioux Falls, SD. Individual provider (NPI-1).
NPI number1164060950
StatusActive
Last updated in NPPESDec 12, 2019
Details
- NPI
- 1164060950
- Entity type
- Individual (NPI-1)
- Name
- John Dylan Shape
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 12, 2019
- Certification date
- Dec 12, 2019
- Last updated
- Dec 12, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 0601 | SD | Yes |
Practice location
810 E 23rd StSioux Falls, SD 57105-2135
Phone 605-977-6845
Mailing address
810 E 23rd StSioux Falls, SD 57105-2135
Phone 605-977-6845
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All 84 Athletic Trainer providers in Sioux Falls · All 8,265 providers in Sioux Falls
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