Individual
LAURA CELESTE SHELTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, ATC
Contact information
Practice address
5243 RIVERSIDE DR APT 1113, MACON, GA 31210-0881
(229) 563-2420
Mailing address
5243 RIVERSIDE DR. APT 1113, MACON, GA 31210
(229) 563-2420
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT001823
GA
Other
Enumeration date
08/10/2011
Last updated
08/10/2011
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