Individual
PHILIP SHADLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
413 SPRING RIDGE DR, DAWSONVILLE, GA 30534-6145
(678) 751-5340
Mailing address
413 SPRING RIDGE DR, DAWSONVILLE, GA 30534-6145
(678) 751-5340
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
01/08/2016
Last updated
01/08/2016
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