NPI 1104366475

Jordan Shangreaux, MSLATATC

Practitioner Athletic Trainer Aberdeen, SD

Practice location

Address: 2200 S Roosevelt St, Aberdeen, SD 57401
Phone: (605) 280-4697
Mailing address: 1736 S 2nd St, Aberdeen, SD 57401-7416

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 0472 (SD)

Other Specialist/Technologist providers in South Dakota →

Registry record

NPI: 1104366475
Entity type: Individual
Sex (as registered): Male
NPI issued: 6 Mar 2017
Record last updated: 20 Dec 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.