Individual
MS. MARY ANN SHELTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMBT
Contact information
Practice address
112 BOEYKENS PL, SUITE 3E, NORMAL, IL 61761-2152
(309) 310-9730
Mailing address
112 BOEYKENS PL, SUITE 3E, NORMAL, IL 61761-2152
(309) 310-9730
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227017812
IL
Other
Enumeration date
01/07/2016
Last updated
01/07/2016
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