Individual
SHANITA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1245 STONEY FIELD PL, LAWRENCEVILLE, GA 30043-3830
(813) 475-9970
Mailing address
1245 STONEY FIELD PL, LAWRENCEVILLE, GA 30043-3830
(813) 475-9970
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
06/11/2020
Last updated
06/11/2020
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