Individual
MIYAH ANTIONETTE SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 BROAD ST STE 104, DURHAM, NC 27705-3573
(919) 537-6565
Mailing address
1200 BROAD ST STE 104, DURHAM, NC 27705-3573
(919) 537-6565
Taxonomy
Speciality
Code
Description
License number
State
2278H0200X
Home Health Certified Respiratory Therapist
Primary
—
—
Other
Enumeration date
04/24/2020
Last updated
04/24/2020
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