Shane Caudill

NPI #1073900650 in Belleville, Illinois

Provider Information

NPI Number: 1073900650
Entity Type: Individual
Name: Shane Caudill
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Apr 21, 2015
Last Updated: Apr 21, 2015

Practice Location

Address: 2600 W MAIN ST
City: Belleville
State: Illinois
ZIP Code: 62226-6651
Phone: (618) 239-6109

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist/Technologist - Athletic Trainer — Athletic Trainer	2255A2300X
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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