Individual
JACK P SHELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
615 ELSINORE PL STE 500, CINCINNATI, OH 45202-1455
(513) 231-6630
Mailing address
1110 E MAIN ST APT 210, LEBANON, OH 45036-6444
(513) 883-8817
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S.2309726
OH
Other
Enumeration date
02/08/2023
Last updated
08/18/2023
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