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General NPI Number Information
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NPI Number | 1578017513
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Entity Type | Individual
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Provider Name | SHELBY BARTER
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Gender | Female
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Dates
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Enumeration Date | 08/08/2016
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Last Update Date | 08/08/2016
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Provider Practice Location Address
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Address Line | 7005 N CAREFREE CIR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80922-2400
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Country | US
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Telephone | 503-707-4003
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Fax |
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Provider Business Mailing Address
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Address Line | 1439 ACACIA DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907-4805
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT.0001534
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License Number State | CO
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