Individual
KELLY GRACE SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14664 DECOURCEY ST, RITTMAN, OH 44270-1010
(330) 398-8835
Mailing address
14664 DECOURCEY ST, RITTMAN, OH 44270-1010
(330) 398-8835
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
01/25/2024
Last updated
01/25/2024
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