Individual
ELLEN D SHANKLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2443 WOODCHUCK ST NE, CANTON, OH 44705-3262
(330) 495-1543
Mailing address
2443 WOODCHUCK ST NE, CANTON, OH 44705-3262
(330) 495-1543
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2674879
—
OH
Enumeration date
05/29/2008
Last updated
05/29/2008
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