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General NPI Number Information
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NPI Number | 1770202996
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Entity Type | Individual
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Provider Name | COLLIN ANDREW SHOEMAKER
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Gender | Male
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Dates
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Enumeration Date | 08/23/2022
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Last Update Date | 09/17/2024
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Provider Practice Location Address
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Address Line | 1000 MAIN ST
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City | CHADRON
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State | NE
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Zip | 69337-2690
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Country | US
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Telephone | 918-284-0483
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Fax |
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Provider Business Mailing Address
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Address Line | 925 MAIN ST APT 1
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City | CHADRON
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State | NE
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Zip | 69337-2746
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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