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Rose Lee Shaddon, TAXI
Driver in Russellville, Arkansas
NPI 1235833302

Rose Lee Shaddon is a Driver based in Russellville, AR. Rose Lee Shaddon practices in Russellville, AR and has the professional credentials of TAXI. The NPI Number for Rose Lee Shaddon is 1235833302 and holds a License No. 0421-016067 (Arkansas).

The current practice location address for Rose Lee Shaddon is 705 Williamson Way, Russellville, AR and can be reached out via phone at 479-280-2132.

Location: 705 Williamson Way, Russellville, AR, 72801-6923
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1235833302
Provider Name
Rose Lee Shaddon
Credential
TAXI
Provider Entity Type
Individual
Gender
Female
Address
705 Williamson Way, Russellville, AR, 72801-6923
Phone Number
479-280-2132
Fax Number
Provider Enumeration Date
03/30/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
705 Williamson Way
City
Russellville
State
Arkansas
Zip
72801-6923
Phone Number
479-280-2132
Fax Number
person
Provider Business Mailing Address Details
Address
705 Williamson Way
City
Russellville
State
Arkansas
Zip
72801-6923
Phone Number
479-280-2132
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Driver
Speciality
-
Taxonomy
172A00000X
License No.
0421-016067 (Arkansas)
Definition
A person employed to operate a motor vehicle as a carrier of persons or property.
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