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1891417580
KENNETH SHAW
BRISTOL, TN
NPI
1891417580
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: TN 2994)
Enumeration Date
2022-09-19
Last Update Date
2022-09-19
Business Address
KENNETH SHAW ATC, LAT
1350 KING COLLEGE RD
BRISTOL, TN 37620-2632
Phone number: 800-362-0014
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Mailing Address
KENNETH SHAW ATC, LAT
362 GRANDVIEW ST
CHURCH HILL, TN 37642-3828
Phone number:
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