Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist |
NPI | 1174698252 |
---|---|
Provider Name | Mr. Jeffery A. Shelton |
First Address | Asheville, NC 28803-1145 |
Second Address | Asheville, NC 28805-2043 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2006 |
Last Update Date | 08/07/2007 |