MRS. Shelley Diane Mack

NPI #1134435092 in Grovetown, Georgia

Provider Information

NPI Number: 1134435092
Entity Type: Individual
Name: MRS. Shelley Diane Mack
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Chore Provider
Enumeration Date: Aug 29, 2010
Last Updated: Aug 29, 2010

Practice Location

Address: 1514 BALDWIN LAKES DR
City: Grovetown
State: Georgia
ZIP Code: 30813-5887
Phone: (706) 854-0555

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chore Provider	372500000X	Primary
Homemaker	376J00000X

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