Individual
SHANELE KANEISHA COBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1475 1ST AVE SW, JACKSONVILLE, AL 36265-3337
(256) 435-9386
Mailing address
1475 1ST AVE SW, JACKSONVILLE, AL 36265-3337
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH10481
AL
Other
Enumeration date
08/05/2021
Last updated
08/05/2021
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