Individual
SHELLY HEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
3725 W 4100 S, WEST VALLEY CITY, UT 84120-5530
(801) 679-0123
Mailing address
3725 W 4100 S, WEST VALLEY CITY, UT 84120-5530
(801) 679-0123
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
6320111-4810
UT
Other
Enumeration date
08/11/2015
Last updated
08/11/2015
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