MS. Jennifer Michelle Shull

NPI #1225382443 in Rockford, Illinois

Provider Information

NPI Number: 1225382443
Entity Type: Individual
Name: MS. Jennifer Michelle Shull
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Technician, Other
Enumeration Date: Nov 9, 2012
Last Updated: Nov 9, 2012

Practice Location

Address: 6905 E STATE ST
City: Rockford
State: Illinois
ZIP Code: 61108-2692
Phone: (815) 397-4142

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician, Other	247200000X	Primary

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