Individual
MR. AUNDRAY TERALL SHACKELFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PROSTHETICSPECIALIST
Contact information
Practice address
105 RANKIN BLVD EXT, TUPELO, MS 38801-4611
(662) 260-1239
Mailing address
204 CITY POINT RD, TUPELO, MS 38801-8637
(662) 260-1239
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
Other
Enumeration date
11/17/2019
Last updated
11/17/2019
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