Individual
SHUNDREA NEELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HAIR LOSS SPECIALIST
Contact information
Practice address
10301 LINCOLN TRL, FAIRVIEW HEIGHTS, IL 62208-1829
(618) 560-3068
Mailing address
2 MONTCLAIR DR, FAIRVIEW HEIGHTS, IL 62208-1627
(618) 560-3068
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
Other
Enumeration date
05/03/2019
Last updated
05/03/2019
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