Individual
PAULA SHELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9317 HERITAGE DR, BLACK HAWK, SD 57718-9230
(308) 760-5125
Mailing address
9317 HERITAGE DR, BLACK HAWK, SD 57718-9230
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
08/26/2019
Last updated
08/26/2019
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