Individual
MS. SHELLEY EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
STNA
Contact information
Practice address
315 E INNIS AVENUE, COLUMBUS, OH 43207-1955
(404) 884-6844
Mailing address
315 E INNIS AVE, COLUMBUS, OH 43207-1955
(404) 884-6844
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3137886
—
OH
Enumeration date
09/25/2014
Last updated
11/29/2014
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