Most Relevant Information
Provider Data
| NPI Number: | 1003345091 |
| Provider Name: | SHELBY WILFONG |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/05/2017 |
| Last Updated: | 06/05/2017 |
Provider Practice Location
110 N MILL ST
FESTUS
MO
630281816
Practice Location Phone/Fax
| Phone: | 6369312700 |
| Fax: | 6369311961 |
Provider Mailing Location
227 MAIN ST
FESTUS
MO
630281952
Provider Mailing Phone/Fax
| Phone: | 6369312700 |
| Fax: | 6369315304 |