Individual
SHELLI HERSETH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC/L
Contact information
Practice address
179 N STARBOARD DR, GILBERT, AZ 85234-6091
(602) 550-1718
Mailing address
179 N STARBOARD DR, GILBERT, AZ 85234-6091
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
604
NM
Other
Enumeration date
02/05/2016
Last updated
02/05/2016
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