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Individual

MS. KELLY C SHINALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
2205 JEFFERSON DAVIS DR, OXFORD, MS 38655-5221
(662) 238-2800
(662) 238-2808
Mailing address
PO BOX 1016, OXFORD, MS 38655-5221
(662) 238-2800
(662) 238-2808

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0980
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00116616
MS
Enumeration date
07/03/2006
Last updated
11/09/2009
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