Individual
LANDRY D SHELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3131 TROUP HWY, TYLER, TX 75701-8350
(903) 534-0449
Mailing address
4055 HOGAN DR APT 702, TYLER, TX 75709-6934
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
218519
TX
Other
Enumeration date
12/06/2024
Last updated
12/06/2024
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