Gloria Jean Shackelford

NPI #1609261056 in Wauchula, Florida

Provider Information

NPI Number: 1609261056
Entity Type: Individual
Name: Gloria Jean Shackelford
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Enumeration Date: Apr 2, 2015
Last Updated: Apr 2, 2015

Practice Location

Address: 114 W ORANGE ST
City: Wauchula
State: Florida
ZIP Code: 33873
Phone: (863) 773-5646

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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