Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SHYANN WALLACE, ATC, LAT
Active Sole ProprietorSHYANN WALLACE, ATC, LAT is a Athletic Trainer healthcare provider located in LEBANON, Pennsylvania. NPI 1710524913 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · LEBANON, PA
Registration Details
- NPI Number
- 1710524913
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Dec 6, 2019 (6.6485612544398 yrs)
- Last Updated
- Jan 11, 2021
- License
-
RTO000512 (PA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1150 HARVEST DRLEBANON, PA, 170461574Browse PA providers · Browse ZIP 17046
- Phone
- 7173769110
- Primary Specialty
-
Athletic Trainer
2255A2300X
- Additional Specialty
- Athletic Trainer
Other Athletic Trainer Providers in LEBANON, PA
| Name | Credential | NPI |
|---|---|---|
| MR. CHRISTOPHER ALLYN SELDOMRIDGE | LAT, ATC. PES, CEAS | 1124185145 |
| MRS. HANNA L NEWELL-SEYFERT | ATC | 1144350331 |
| HEATHER LEIGH BRATTON | PA-C., ATC, CES, PES | 1134338866 |
| HEATHER TOBIAS | ATC, LAT | 1144677006 |
| SEAN DOUGHERTY | ATC | 1477157154 |
| HANNAH ELIZABETH BASHORE | MS, LAT, ATC | 1538024435 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.