Individual
GARY SHELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
606 E SHERIDAN RD, MELBOURNE, FL 32901-3227
(321) 727-0984
Mailing address
436 FRANKLIN ST, PADUCAH, KY 42003-0435
(270) 556-3842
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
13961
FL
Other
Enumeration date
10/18/2007
Last updated
10/18/2007
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