Individual
JODY DIANE MASHINTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
2300 MACCORKLE AVE SE, CHARLESTON, WV 25304-1045
(304) 357-4814
Mailing address
2300 MACCORKLE AVE SE, CHARLESTON, WV 25304-1045
(304) 357-4814
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT001362
WV
Other
Enumeration date
08/26/2014
Last updated
08/26/2014
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