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Individual

MRS. KOSIE L SHEPHERD-PORADA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, ATC

Contact information

Practice address
927 MENOHER BLVD, JOHNSTOWN, PA 15905-2834
(814) 255-6814
(814) 255-7963
Mailing address
927 MENOHER BLVD, JOHNSTOWN, PA 15905-2834
(814) 255-6814
(814) 255-7963

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT003694
PA

Other

Enumeration date
04/07/2009
Last updated
04/07/2009
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