Individual
RENA LACHELLE SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6434 E 52ND ST, INDIANAPOLIS, IN 46226-2588
(463) 224-4397
Mailing address
55 MONUMENT CIR STE 222A, INDIANAPOLIS, IN 46204-2910
(463) 224-4397
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
07/06/2024
Last updated
07/06/2024
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