Individual
MISS SHANICK TAMARA AUGUSTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
8945 W COLONIAL DR, OCOEE, FL 34761-6918
(407) 822-7506
Mailing address
7220 WESTPOINTE BLVD, #1426, ORLANDO, FL 32835-6126
(407) 496-5152
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL2296
FL
Other
Enumeration date
04/19/2007
Last updated
12/17/2008
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