Individual
MRS. SHANNON GEORGE GROOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
346 SENATORS RIDGE DR, DALLAS, GA 30132-1256
(770) 505-3333
(678) 809-0467
Mailing address
346 SENATORS RIDGE DR, DALLAS, GA 30132-1256
(770) 505-3333
(678) 809-0467
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
646315
GA
Other
Enumeration date
09/23/2013
Last updated
09/23/2013
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