Shae E Anderson, ATC
Specialist/Technologist, Athletic Trainer in Springfield, MO. Individual provider (NPI-1).
NPI number1346638426
StatusActive
Last updated in NPPESDec 24, 2014
Details
- NPI
- 1346638426
- Entity type
- Individual (NPI-1)
- Name
- Shae E Anderson
- Credential
- ATC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 24, 2014
- Last updated
- Dec 24, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 2014012710 | MO | Yes |
Practice location
4331 S Fremont AveSpringfield, MO 65804-7328
Phone 417-820-5010
Mailing address
617 E Grand StApt 4
Springfield, MO 65807-1655
Phone 618-210-3940
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