Provider Demographics
NPI:1154351591
Name:CROWE, SHALIMAR SHEREE (ATC/L)
Entity type:Individual
Prefix:MRS
First Name:SHALIMAR
Middle Name:SHEREE
Last Name:CROWE
Suffix:
Gender:F
Credentials:ATC/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:491 CAREYTOWN RD
Mailing Address - Street 2:
Mailing Address - City:ROYSTON
Mailing Address - State:GA
Mailing Address - Zip Code:30662-3304
Mailing Address - Country:US
Mailing Address - Phone:706-245-8657
Mailing Address - Fax:
Practice Address - Street 1:181 SPRING ST
Practice Address - Street 2:
Practice Address - City:ROYSTON
Practice Address - State:GA
Practice Address - Zip Code:30662
Practice Address - Country:US
Practice Address - Phone:706-245-7226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0010202255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer