Individual
SHANITA LEANNA JEFFERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.K.T.
Contact information
Practice address
3600 W BROAD ST, RICHMOND, VA 23230-4915
(804) 585-6723
Mailing address
3509 FESTIVAL PARK PLZ, CHESTER, VA 23831-4449
(804) 621-5462
Taxonomy
Speciality
Code
Description
License number
State
224Y00000X
Clinical Exercise Physiologist
Primary
—
IN
Other
Enumeration date
01/24/2019
Last updated
07/14/2019
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