Individual
SHANIECE A CRAFT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
620 SKYLINE DR, JACKSON, TN 38301-3923
(731) 541-5000
(731) 664-0057
Mailing address
720 WESTVIEW DR SW, ATLANTA, GA 30310-1458
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
71720
TN
Other
Enumeration date
05/03/2019
Last updated
10/04/2024
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