TRAVIS JON SHOCK

FARGO, ND
NPI1689760845
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: ND  271-03)
Additional Taxonomies2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MN  1792)
Enumeration Date2006-10-05
Last Update Date2007-07-08
Business Address
Mr. TRAVIS JON SHOCK ATC
2400 32ND AVE S
FARGO, ND 58103-5800
Phone number: 218-643-2694
Mailing Address
Mr. TRAVIS JON SHOCK ATC
1510 AVENUE B
WAHPETON, ND 58075-3760
Phone number: 701-672-4513