Individual
TANISHA SHUANTE RILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
702 VAN STREAT HWY, NICHOLLS, GA 31554-4017
(912) 501-4094
(708) 367-6703
Mailing address
702 VAN STREAT HWY, NICHOLLS, GA 31554-4017
(912) 501-4094
(708) 367-6703
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
10/22/2025
Last updated
10/22/2025
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