Individual
JESSICA SHOCKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.O.A
Contact information
Practice address
105 SUGAR CAMP CIR, SUITE 200, DAYTON, OH 45409-1962
(937) 222-3937
(937) 223-5254
Mailing address
105 SUGAR CAMP CIR, SUITE 200, DAYTON, OH 45409-1962
(937) 222-3937
(937) 223-5254
Taxonomy
Speciality
Code
Description
License number
State
156FX1101X
Ophthalmic Assistant
Primary
180446
OH
Other
Enumeration date
06/13/2012
Last updated
06/13/2012
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