SHANE MICHAEL OSGOOD

TWIN FALLS, ID
NPI1144466889
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist Athletic Trainer
(Licence: ID  AT-509)
Additional Taxonomies2255A2300X Specialist/Technologist Athletic Trainer
(Licence: NY  002043-1)
Enumeration Date2008-12-31
Last Update Date2014-09-05
Business Address
MR. SHANE MICHAEL OSGOOD ATC, CEAS
833 SHOSHONE ST N
TWIN FALLS, ID 83301-6370
Phone number: 607-377-7850
Mailing Address
MR. SHANE MICHAEL OSGOOD ATC, CEAS
PO BOX 2126
TWIN FALLS, ID 83303-2126
Phone number: 607-377-7850
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