Individual
CHARLES L SHIVLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
240 W TYRONE RD, OAK RIDGE, TN 37830-6517
(865) 482-1076
Mailing address
240 W TYRONE RD, OAK RIDGE, TN 37830-6517
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
09/18/2018
Last updated
09/18/2018
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