Individual
SHANNON LARATONDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD, MBA, MHS
Contact information
Practice address
619 N PROVIDENCE RD # 4355, COLUMBIA, MO 65203-4355
(573) 234-1070
Mailing address
3605 BRIARMONT AVE APT 311, COLUMBIA, MO 65201-3678
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
1134368962
MO
Other
Enumeration date
04/17/2020
Last updated
04/17/2020
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