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General NPI Number Information
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NPI Number | 1992835227
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Entity Type | Individual
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Provider Name | KORIE LYNNE SHEETS ATC,LAT
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Gender | Female
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 700 EAGLE
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City | DESOTO
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State | TX
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Zip | 75115
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Country | US
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Telephone | 972-274-8289
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Fax |
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Provider Business Mailing Address
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Address Line | 613 ORCHARD LN
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City | FORNEY
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State | TX
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Zip | 75126-9096
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Country | US
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Telephone | 469-474-9612
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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 | AT2455
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License Number State | TX
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