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Individual

HELEN DIANE SHORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC, LAT

Contact information

Practice address
201 SANDCRAB BLVD, PORT LAVACA, TX 77979-2424
(361) 551-2698
Mailing address
201 WHISPERING PINE DR, HAUGHTON, LA 71037-9512
(903) 279-2603

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT3380
TX

Other

Enumeration date
02/04/2010
Last updated
02/04/2010
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