Individual
KEVIN WAYNE SHELTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
4073 N FRUIT AVE APT 117, FRESNO, CA 93705-2136
(559) 720-9493
Mailing address
4073 N FRUIT AVE APT 117, FRESNO, CA 93705-2136
(559) 720-9493
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
78975
CA
Other
Enumeration date
11/18/2020
Last updated
11/18/2020
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