Individual
BEVERLY LYNN SHELTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1165 MICHIGAN ST, BELLEFONTAINE, OH 43311-2518
(937) 592-0545
Mailing address
1165 MICHIGAN ST, BELLEFONTAINE, OH 43311-2518
(937) 592-0545
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2670024
—
OH
Enumeration date
03/23/2007
Last updated
07/08/2007
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