Samuel Lee Shepard
Samuel Lee Shepard is a Student in an Organized Health Care Education/Training Program in Dayton, Ohio. Practices as a sole proprietor. Licensed in Oklahoma.
- Licensed in
- OK
- In the registry since
- 2021
Practice location Address checks out
405 W Grand AveDayton, OH 45405-7538
Phone: (937) 723-3200
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Specialties & licences
| Student in an Organized Health Care Education/Training Program (primary) | Taxonomy 390200000X (OK) |
|---|
Record details
| NPI number | 1730842840 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | October 15, 2021 |
| Last updated in NPPES | March 19, 2024 |
| Certification date | March 19, 2024 |
| Mailing address | 1111 W 17th St, Tulsa, OK 74107-1886 |
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