Individual
DYRAL KEITH SHANKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
402 LINCOLN ST, WADESBORO, NC 28170-2013
(704) 294-5076
Mailing address
140 RIVER DR, WADESBORO, NC 28170-6515
(704) 465-1470
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
08/12/2016
Last updated
09/09/2019
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