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1346594264
MICHAEL WAYNE SHETLEY
APPOMATTOX, VA
NPI
1346594264
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
(Licence: VA 0126000490)
Enumeration Date
2012-10-30
Last Update Date
2012-10-30
Business Address
MR. MICHAEL WAYNE SHETLEY ATC, CSCS
198 EVERGREEN AVE
APPOMATTOX, VA 24522
Phone number: 804-539-5080
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Mailing Address
MR. MICHAEL WAYNE SHETLEY ATC, CSCS
179 GLENN CARSON RD
PROSPECT, VA 23960-2112
Phone number: 804-539-5080
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