NPI 1134435092
Shelley Diane Mack
Practice location
- Address
- 1514 Baldwin Lakes Dr, Grovetown, GA 30813-5887
- Phone
- (706) 854-0555
- Fax
- (706) 651-9677
Registered specialties (2)
Chore Provider
Primary
Homemaker
Registry record
- NPI
- 1134435092
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 29 Aug 2010
- Record last updated
- 29 Aug 2010
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.