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Search › Georgia › 372500000X

Shelley Mack

NPI 1134435092 · on the registry since 2010 · sole proprietor

Practice

Address
1514 Baldwin Lakes Dr
Grovetown, GA 30813
Phone
(706) 854-0555
Fax
(706) 651-9677
Organisation at this address
Macklander, Llc
Lizzy'S Adult Community Service Center
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy
372500000X
372500000X
Also registered as
376J00000X
Sex
Female
Record last updated
2010-08-29

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia