SHANNON ELIZABETH DERRICKS

SPRINGFIELD, MO
NPI1114919057
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MO  109649)
Enumeration Date2005-08-17
Last Update Date2007-07-08
Business Address
Ms. SHANNON ELIZABETH DERRICKS ATC
901 S NATIONAL AVE ATHLETIC TRAINING SERVICES
SPRINGFIELD, MO 65804-0027
Phone number: 417-836-5461
Mailing Address
Ms. SHANNON ELIZABETH DERRICKS ATC
901 S NATIONAL AVE ATHLETIC TRAINING SERVICES
SPRINGFIELD, MO 65804-0027
Phone number: