Individual
COLIN MARK SHILLINGLAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
1319 EARL CAMPBELL PKWY, TYLER, TX 75701-9697
(903) 262-1000
Mailing address
10839 CACTUS TRL, FLINT, TX 75762-8773
(254) 733-5234
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1039
TX
Other
Enumeration date
11/21/2019
Last updated
11/21/2019
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