Individual
KHALELAH SHACKLEFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 UNIVERSITY RD, PEMBROKE, NC 28372-8699
(252) 624-4911
Mailing address
6428 NC HIGHWAY 903 S, LA GRANGE, NC 28551-8362
(125) 262-4491
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
12/28/2023
Last updated
12/28/2023
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