Individual
SHELBY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
4310 APPLEBY SAND RD, NACOGDOCHES, TX 75965-2232
(936) 564-2466
Mailing address
4310 APPLEBY SAND RD, NACOGDOCHES, TX 75965-2232
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT5794
TX
Other
Enumeration date
07/24/2019
Last updated
07/24/2019
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