Charlene R. Shank
Individual provider Active NPI Athletic Trainer · Manchester, PA
NPI 1124243068 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1124243068
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- RT001469A (PA)
- Practice address
- 300 High St
Manchester, PA 17345-1508 - Phone
- (717) 266-3644
- Fax
- (717) 266-0616
- NPI assigned
- Apr 16, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RT001469A | PA | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | RT001469A | PA | Yes |
Addresses
Primary practice location
300 High St
Manchester, PA 17345-1508
Mailing address
2505 Bremer Rd
Dover, PA 17315-2051
Phone (717) 292-5932
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2255A2300X | Other | PA | ATHLETIC TRAINER |
Other providers in Manchester, PA
- Rite Aid of Pennsylvania LLC
- Eugenia Margarita Rodriguez Soto
- Thomas G Roth
- Royal Presence Professional Services, LLC
- Sans Pareil Eyecare
- Jennifer Lyn Small
- Thomas Stein Jr.
- Madison Teague
- Monique S Terry
- Candice Throne
All providers in Manchester, PA · Athletic Trainer in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.