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Individual

MS. KELLY JO SHUMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MT

Contact information

Practice address
135 CIMARRON RD, NUTTER FORT, WV 26301-4374
(304) 623-5551
(304) 623-5552
Mailing address
135 CIMARRON RD, NUTTER FORT, WV 26301-4374
(304) 623-5551
(304) 623-5552

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2000-479
WV

Other

Enumeration date
12/01/2006
Last updated
07/08/2007
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