MS. SHANNON DERRICKS, ATC
Specialist/Technologist - Athletic Trainer
Active
Individual
NPI: 1114919057
Practice Address
901 S NATIONAL AVEATHLETIC TRAINING SERVICES
Springfield, MO 65804
Phone: (417) 836-5461
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Specialist/Technologist - Athletic Trainer | 2255A2300X | Yes | 109649 (MO) |
Frequently Asked Questions
NPI 1114919057 is the National Provider Identifier for MS. SHANNON DERRICKS, ATC, a Specialist/Technologist - Athletic Trainer provider located in Springfield, MO. This NPI was enumerated on August 17, 2005.
MS. SHANNON DERRICKS, ATC practices at 901 S NATIONAL AVE, ATHLETIC TRAINING SERVICES, Springfield, MO 65804.
Quick Facts
- NPI
- 1114919057
- Type
- Individual
- Enumerated
- Aug 17, 2005
- Last Updated
- Jul 8, 2007
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