Individual
TIERRA SHOPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
840 WOOD ST, CLARION, PA 16214-1232
(814) 393-2102
Mailing address
918 SCHOFIELD ST, CURWENSVILLE, PA 16833-1551
(814) 553-1663
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT007012
PA
Other
Enumeration date
12/06/2019
Last updated
12/06/2019
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