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1336361310
CHARLES LEWIS SHADLE
GAINESVILLE, GA
NPI
1336361310
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: GA OT002793)
Enumeration Date
2007-05-02
Last Update Date
2007-07-08
Business Address
Mr. CHARLES LEWIS SHADLE OT
743 SPRING ST NE
GAINESVILLE, GA 30501-3715
Phone number: 770-533-8252
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Mailing Address
Mr. CHARLES LEWIS SHADLE OT
PO BOX 1035
LULA, GA 30554-1035
Phone number: 770-869-0880
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