Individual
SHAWANDER HURT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
106 BRIGHTON RD, GREENSBORO, GA 30642-1602
(706) 816-5779
Mailing address
106 BRIGHTON RD, GREENSBORO, GA 30642-1602
(706) 816-5779
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CN0000017193
GA
Other
Enumeration date
02/04/2015
Last updated
02/04/2015
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