Doctor Name: | BEVERLY LYNN SHELTON |
NPI Number: | 1225155518 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 1165 Michigan St Bellefontaine, OH - 433112518 |
Business Phone Number: | 9375920545 |
Business Fax Number: | |
Mailing Address: | 1165 Michigan St, BELLEFONTAINE |
State: | OH |
Postal Code: | 433112518 |
Phone Number: | 9375920545 |
Fax Number: | |
NPI Enumeration Date: | 03/23/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 171WH0202X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Contractor |
Taxonomy Specialization: | Home Modifications |
Taxonomy Definition: |