Individual
SHALONDA THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2613 TOBACCO ROAD, AUGUSTA, GA 30815-3081
(912) 531-0694
Mailing address
2613 TOBACCO ROAD, AUGUSTA, GA 30815
(912) 531-0694
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
081999
GA
Other
Enumeration date
03/24/2021
Last updated
03/24/2021
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