JOHN DYLAN SHAPE

SIOUX FALLS, SD
NPI1164060950
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: SD  0601)
Enumeration Date2019-12-12
Last Update Date2019-12-12
Business Address
JOHN DYLAN SHAPE
810 E 23RD ST
SIOUX FALLS, SD 57105-2135
Phone number: 605-977-6845
Mailing Address
JOHN DYLAN SHAPE
810 E 23RD ST
SIOUX FALLS, SD 57105-2135
Phone number: 605-977-6845
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