Individual
TERRA SHED-BOOTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2831 E WYNNTON LN, COLUMBUS, GA 31906-2167
(706) 332-2092
Mailing address
2831 E WYNNTON LN, COLUMBUS, GA 31906-2167
(706) 332-2092
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
12/09/2011
Last updated
12/14/2018
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