Individual
JORDAN DEVON SHELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
948 GA-138, RIVERDALE, GA 30296
(404) 966-9451
Mailing address
948 GA-138, RIVERDALE, GA 30296
(404) 966-9451
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT010523
GA
Other
Enumeration date
02/08/2022
Last updated
02/08/2022
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