Individual
KAITLIN MARIE SHINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
174 POLONIA AVE, COVENTRY TOWNSHIP, OH 44319-3015
(330) 432-1919
Mailing address
1976 BURROW RD SW, CARROLLTON, OH 44615-8244
(330) 432-1919
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT006339
OH
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
01/31/2019
Last updated
05/17/2021
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