Individual
MR. SHAWN MICHAEL TACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, ATC/L
Contact information
Practice address
2300 HIGHLAND RD, BATESVILLE, AR 72501-3629
(870) 307-7331
(870) 307-7524
Mailing address
10 BIG PINE RD, BATESVILLE, AR 72501-7375
(870) 834-4731
(870) 307-7524
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT 362
AR
Other
Enumeration date
02/15/2006
Last updated
11/29/2011
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