Individual
MR. TERRY D SHELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1608 W MCGALLIARD RD, MUNCIE, IN 47304-2205
(765) 289-4727
(765) 751-2207
Mailing address
1608 W MCGALLIARD RD, MUNCIE, IN 47304-2205
(765) 289-4727
(765) 751-2207
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18001461B
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100150060A
—
IN
Enumeration date
08/31/2006
Last updated
10/12/2011
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