Individual
JAEBIN SHIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSED, ATC, CSCS
Contact information
Practice address
323 EAGLE BLVD., GOODWELL, OK 73939
(580) 349-1338
(580) 349-1419
Mailing address
720 HACKBERRY, PO BOX 622, GOODWELL, OK 73939
(703) 303-0015
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
847
OK
Other
Enumeration date
02/05/2018
Last updated
02/05/2018
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