Individual
SHAWN THOMAS KLENK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
102 REX RD., SOMERDALE, NJ 08083
(856) 309-9292
Mailing address
102 REX RD., SOMERDALE, NJ 08083
(856) 309-9292
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00066800
NJ
Other
Enumeration date
02/22/2007
Last updated
07/08/2007
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