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Individual

SHELLY RENEA OBASOLUYI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
403 ATWELL DR, FAYETTEVILLE, NC 28314-0122
(910) 260-8842
Mailing address
403 ATWELL DR, FAYETTEVILLE, NC 28314-0122
(910) 260-8842

Taxonomy

Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
NC

Other

Enumeration date
05/30/2019
Last updated
05/30/2019
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