Individual
MR. DEREK S SHAFFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC,LAT
Contact information
Practice address
1055 HIGHLAND BLVD, CABOT, AR 72023-6001
(501) 412-3717
Mailing address
1055 HIGHLAND BLVD, CABOT, AR 72023-6001
(501) 412-3717
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT370
AR
Other
Enumeration date
04/19/2007
Last updated
07/08/2007
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