Individual
MRS. SHELLEY MARIE KOHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
C.P.C.P. CERT.
Contact information
Practice address
425 E. CENTER ST SUITE 1, MANTECA, CA 95336
(209) 456-7056
(209) 239-3033
Mailing address
425 E CENTER ST STE 1, MANTECA, CA 95336-4727
(209) 456-7056
(209) 239-3033
Taxonomy
Speciality
Code
Description
License number
State
246ZA2600X
Medical Art Specialist/Technologist
Primary
—
—
Other
Enumeration date
06/15/2012
Last updated
06/15/2012
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