Individual
SHEA RAE DAWN HOFFMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
310 COLLEGE ST, BARBOURVILLE, KY 40906-1410
(606) 546-1303
Mailing address
5207 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25309-1009
(304) 552-2700
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
TCA679
KY
2255A2300X
Athletic Trainer
—
WV
390200000X
Student in an Organized Health Care Education/Training Program
—
WV
Other
Enumeration date
02/23/2018
Last updated
09/28/2018
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