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1114352358
SHANE CHRISTOPHER NELSON
GARDEN CITY, ID
NPI
1114352358
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: ID AT-702)
Enumeration Date
2013-09-06
Last Update Date
2023-02-13
Business Address
SHANE CHRISTOPHER NELSON ATC
5600 W GLENWOOD ST
GARDEN CITY, ID 83714
Phone number: 319-325-4177
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Mailing Address
SHANE CHRISTOPHER NELSON ATC
520 S EAGLE RD
MERIDIAN, ID 83642-6351
Phone number:
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