Individual
MR. JEFFREY DONALD SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC,MED
Contact information
Practice address
75 EVELYN DR, MILLERSBURG, PA 17061-1258
(717) 692-4708
Mailing address
511 COLONY DR, MIDDLETOWN, PA 17057-5608
(717) 939-1153
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT000334A
PA
Other
Enumeration date
03/13/2007
Last updated
07/08/2007
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