Provider Demographics
NPI:1417969718
Name:CADMAN, SHELLY ANN (OD)
Entity Type:Individual
Prefix:DR
First Name:SHELLY
Middle Name:ANN
Last Name:CADMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 E FREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:WY
Mailing Address - Zip Code:82501-4421
Mailing Address - Country:US
Mailing Address - Phone:307-856-9000
Mailing Address - Fax:307-856-9004
Practice Address - Street 1:704 E FREMONT AVE
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:WY
Practice Address - Zip Code:82501-4421
Practice Address - Country:US
Practice Address - Phone:307-856-9000
Practice Address - Fax:307-856-9004
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY227T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist