Individual
JOHN SHIFFLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
101 UNIVERSITY DRIVE, RADFORD, VA 24141-6913
(540) 831-6128
Mailing address
PO BOX 6913, RADFORD, VA 24142-6913
(540) 831-6128
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126001271
VA
Other
Enumeration date
12/15/2016
Last updated
12/15/2016
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