Individual
SHAMICAH SHANELL TARDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2335 SPRINGDALE CT APT H4, ALBANY, GA 31707-1624
(229) 443-2061
Mailing address
2335 SPRINGDALE CT APT H4, ALBANY, GA 31707-1624
(229) 443-2061
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
08/25/2021
Last updated
08/25/2021
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