Individual
SHELLY ANN BOTWINICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
104 DAISY CT, JACKSON, NJ 08527-2582
(609) 851-7266
Mailing address
104 DAISY CT, JACKSON, NJ 08527-2582
(609) 851-7266
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
11/07/2019
Last updated
11/07/2019
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