Individual
MRS. SHELIA D CROCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC/L
Contact information
Practice address
1350 KING COLLEGE RD, BRISTOL, TN 37620-2632
(423) 652-4762
(423) 652-6041
Mailing address
1777 WENDOVER RD, BRISTOL, VA 24201-2842
(276) 591-3799
(423) 652-6041
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0000000651
TN
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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