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Individual

DR. SHELLEY K BOONE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1643 W LANE AVE, COLUMBUS, OH 43221-3339
(614) 775-1503
Mailing address
1643 W LANE AVE, COLUMBUS, OH 43221-3339
(614) 775-1503

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
35.088642
OH
208100000X
Physical Medicine & Rehabilitation Physician
D71035
MD
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
35.088642
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2763531
OH
05
540041400
MD
Enumeration date
05/03/2007
Last updated
11/15/2011
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