Individual
MR. KIMBERLY RAE SHAFFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1350 8TH ST, PENROSE, CO 81240-9775
(719) 429-5983
Mailing address
1350 8TH ST, PENROSE, CO 81240-9775
(719) 429-5983
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000007112
CO
Other
Enumeration date
11/01/2011
Last updated
11/01/2011
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