Individual
GENE SHIRLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ROF
Contact information
Practice address
1840 OWEN DR STE 102, FAYETTEVILLE, NC 28304-3455
(910) 484-2645
(910) 484-0866
Mailing address
1840 OWEN DR STE 102, FAYETTEVILLE, NC 28304-3455
(910) 484-2645
(910) 484-0866
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7795271
—
NC
Enumeration date
03/30/2007
Last updated
07/09/2007
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