Individual
SAMANTHA MARIE SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
870 MONTGOMERY ST., JERSEY CITY, NJ 07306
(714) 356-8971
Mailing address
870 MONTGOMERY ST., JERSEY CITY, NJ 07306
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00306800
NJ
Other
Enumeration date
11/25/2022
Last updated
11/25/2022
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