Individual
MARIE SHELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
505 W 400 N, OREM, UT 84057-1950
(801) 714-3450
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 491-6482
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
7617114-1204
UT
390200000X
Student in an Organized Health Care Education/Training Program
125052651
IL
Other
Enumeration date
09/04/2007
Last updated
11/17/2014
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