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Individual

MS. CHARLENE R. SHANK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
300 HIGH ST, MANCHESTER, PA 17345-1508
(717) 266-3644
(717) 266-0616
Mailing address
2505 BREMER RD, DOVER, PA 17315-2051
(717) 292-5932
(717) 266-0616

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT001469A
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2255A2300X
ATHLETIC TRAINER
PA
Enumeration date
04/16/2007
Last updated
07/08/2007
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