PHILLIP ALLEN SHAW

MONROE, LA
NPI1912215906
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist Athletic Trainer
(Licence: LA  J00150)
Enumeration Date2010-09-23
Last Update Date2018-11-10
Business Address
PHILLIP ALLEN SHAW M.ED., A.T.C.
681 HIGHWAY 594
MONROE, LA 71203-8900
Phone number: 318-381-0140
Mailing Address
PHILLIP ALLEN SHAW M.ED., A.T.C.
103 OAK TRL
MONROE, LA 71203-9672
Phone number: 318-381-0140
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