Individual
MIRANDA JANE SHELTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
567 IVY TECH DR, MADISON, IN 47250-1802
(812) 273-6338
Mailing address
134 S HARRISON DR, SEYMOUR, IN 47274-3115
(812) 530-9676
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26027771A
IN
Other
Enumeration date
10/29/2020
Last updated
10/29/2020
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