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Individual

MR. RONALD P. SHELTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
A.T.,C./L

Contact information

Practice address
4675 BLUESTEM RD # 1, ROSCOE, IL 61073-7788
(815) 623-9930
Mailing address
307 SALEM ST, ROCKTON, IL 61072-2630
(815) 624-5040
(815) 623-1691

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.000243
IL

Other

Enumeration date
04/11/2012
Last updated
04/11/2012
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