Individual
KELLY L. SHAFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1306 APPLE GLEN BLVD, FORT WAYNE, IN 46804-1792
(260) 459-6924
(260) 420-0817
Mailing address
10021 DUPONT CIRCLE CT, FORT WAYNE, IN 46825-1604
(260) 426-8117
(260) 420-0817
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
17000821A
IN
Other
Enumeration date
03/11/2013
Last updated
03/11/2013
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