Provider Demographics
NPI:1427460773
Name:FOOKS, SHANNON (ATC)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:FOOKS
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3825 WISCONSIN AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-2907
Mailing Address - Country:US
Mailing Address - Phone:202-537-2464
Mailing Address - Fax:202-537-2438
Practice Address - Street 1:3825 WISCONSIN AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-2907
Practice Address - Country:US
Practice Address - Phone:202-537-2464
Practice Address - Fax:202-537-2438
Is Sole Proprietor?:No
Enumeration Date:2014-05-21
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer