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1043880354
SHELLY GORDON
COVINGTON, GA
NPI
1043880354
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
282J00000X Religious Nonmedical Health Care Institution
Enumeration Date
2021-06-29
Last Update Date
2021-06-29
Business Address
SHELLY GORDON
155 OVERLOOK DR
COVINGTON, GA 30016-8817
Phone number: 678-702-3519
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Mailing Address
SHELLY GORDON
155 OVERLOOK DR
COVINGTON, GA 30016-8817
Phone number: 678-702-3519
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