Individual
LACEY SHIFFLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
307 SPRINGWATER RD, COVINGTON, VA 24426-5716
(540) 968-6199
Mailing address
307 SPRINGWATER RD, COVINGTON, VA 24426-5716
(540) 968-6199
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
12/05/2015
Last updated
12/05/2015
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