Individual
JONATHAN EDWARD SHELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
230 E 12TH ST, ADA, OK 74820-6508
(580) 332-3001
Mailing address
230 E 12TH ST, ADA, OK 74820-6508
(580) 332-3001
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
09/20/2018
Last updated
09/20/2018
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