Individual
MRS. SHELLEY CROOM BLAKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED, ATC
Contact information
Practice address
112 MASSIE ROAD, CHARLOTTESVILLE, VA 22904-9202
(434) 243-2419
Mailing address
1025 HIGHLANDS DR, CHARLOTTESVILLE, VA 22901-9202
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126000282
VA
Other
Enumeration date
12/26/2007
Last updated
12/26/2007
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