Individual
ANDREW SHIROTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2402 FOXY POISE RD, LOUISVILLE, KY 40220-1031
(502) 759-1928
Mailing address
2402 FOXY POISE RD, LOUISVILLE, KY 40220-1031
(502) 759-1928
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/20/2022
Last updated
04/20/2022
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