Individual
TEONDRA SHANTAY MCGRUDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1032 LAKEVIEW ST, LOUISVILLE, GA 30434-5963
(478) 206-2864
Mailing address
1032 LAKEVIEW ST, LOUISVILLE, GA 30434-5963
(478) 206-2864
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
CO131457
GA
Other
Enumeration date
01/14/2019
Last updated
01/14/2019
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