Individual
MS. SHANNON RAE SLAYTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
603 N GRAND AVE, TAHLEQUAH, OK 74464-2302
(214) 762-8109
Mailing address
603 N GRAND AVE, TAHLEQUAH, OK 74464-2302
(214) 762-8109
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
746
OK
Other
Enumeration date
05/04/2015
Last updated
05/04/2015
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