Individual
KAYLA LYNN SHATTUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
100 OMNI DR STE B, SENECA, SC 29672-9448
(864) 886-9250
(864) 886-9251
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4398
SC
Other
Enumeration date
10/19/2015
Last updated
08/21/2023
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