MICHAEL SHANE TIERNEY

MC LEAN, VA
NPI1073197679
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: VA  0126001718)
Enumeration Date2021-05-10
Last Update Date2021-05-10
Business Address
MICHAEL SHANE TIERNEY
1633 DAVIDSON RD
MC LEAN, VA 22101-4399
Phone number: 703-714-5771
Mailing Address
MICHAEL SHANE TIERNEY
1633 DAVIDSON RD
MC LEAN, VA 22101-4399
Phone number: 703-714-5771
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