MS. Shannon Elizabeth Derricks, ATC
NPI #1114919057 in Springfield, Missouri
Provider Information
- NPI Number
- 1114919057
- Entity Type
- Individual
- Name
- MS. Shannon Elizabeth Derricks, ATC
- Gender
- Not Specified
- Sole Proprietor
- Not Answered
- Primary Specialty
- Specialist/Technologist - Athletic Trainer
- Credential
- ATC
- Enumeration Date
- Aug 17, 2005
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 901 S NATIONAL AVE
- Address 2
- ATHLETIC TRAINING SERVICES
- City
- Springfield
- State
- Missouri
- ZIP Code
- 65804-0027
- Phone
- (417) 836-5461
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist - Athletic Trainer — Athletic Trainer |
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