Individual
MRS. SHELLY LEIGH GARVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
202 SOMERSBY DR, DALLAS, GA 30157-8086
(770) 815-7035
(678) 343-9513
Mailing address
202 SOMERSBY DR, DALLAS, GA 30157-8086
(770) 815-7035
(678) 343-9513
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00868876A
—
GA
Enumeration date
12/22/2006
Last updated
07/08/2007
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