Individual
MRS. TIFFANY SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT, C.PH.T
Contact information
Practice address
1200 BOYD RD, AZLE, TX 76020-2522
(817) 444-5555
Mailing address
117 GOLFERS WAY, AZLE, TX 76020-3061
(817) 694-7900
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT3981
TX
Other
Enumeration date
07/21/2016
Last updated
07/21/2016
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