Individual
MRS. SHAWON LYNN GULLETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CERTIFIED HAIR LOSS
Contact information
Practice address
5250 FAR HILLS AVE, DAYTON, OH 45429-2382
(937) 281-0555
Mailing address
5250 FAR HILLS AVE, DAYTON, OH 45429-2382
(937) 281-0555
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
Other
Enumeration date
11/09/2016
Last updated
11/09/2016
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