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Individual

TARA SHELLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
105 ASHLAND AVE, CLINTON, SC 29325-2960
(864) 200-0636
Mailing address
973 OLD MILTON RD, CLINTON, SC 29325-6154
(904) 392-9518

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1692
SC

Other

Enumeration date
01/21/2016
Last updated
01/21/2016
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