Individual
MRS. AMANDA KATHLEEN SHELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSFA
Contact information
Practice address
1725 N 5TH ST, TERRE HAUTE, IN 47804-4010
(812) 242-3005
Mailing address
1725 N 5TH ST, TERRE HAUTE, IN 47804-4010
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
165941
IN
Other
Enumeration date
09/18/2018
Last updated
09/18/2018
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