Individual
SHELLY A MACIAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT
Contact information
Practice address
3307 VICKSBURG AVE, LUBBOCK, TX 79410-2321
(806) 766-0632
Mailing address
2515 COUNTY ROAD 7450, LUBBOCK, TX 79423-6937
(806) 687-1057
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT 1424
TX
Other
Enumeration date
03/06/2007
Last updated
07/08/2007
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