Individual
MR. HERSHEL MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, ATC
Contact information
Practice address
885 SCHUMANN DR, VIRGINIA BEACH, VA 23454-6878
(757) 708-1621
Mailing address
4111 MONARCH WAY STE 500, NORFOLK, VA 23508-2563
(757) 477-6812
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
0126001007
VA
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/20/2019
Last updated
06/07/2023
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