Derricks, Shannon Elizabeth

Derricks, Shannon Elizabeth is an individual health care provider with primary practice located at 901 S National Ave Athletic Training Services, Springfield MO 65804-0027. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as her primary health care specialty. Derricks, Shannon Elizabeth can be contacted via phone (417) 836-5461.

Contact Information

Primary practice address
901 S National Ave Athletic Training Services Springfield MO 65804-0027
Phone: (417) 836-5461
Fax: (417) 836-6101
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X 109649 Missouri

Profile Details

NPI number 1114919057
LBN Legal business name Derricks, Shannon Elizabeth
Credentials Athletic Trainer, Certified (ATC)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 17th, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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