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Individual

SHELBY HARBISON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC, LAT

Contact information

Practice address
171 CAVALRY WAY, BUILDING 161, FORT STEWART, GA 31314
(470) 588-6397
Mailing address
108 S BAYBERRY CT, BLOOMINGTON, IL 61704-4682

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
096005102
IL
2255A2300X
Athletic Trainer
Primary
AT003819
GA

Other

Enumeration date
11/23/2020
Last updated
09/02/2022
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