Individual
SHIRETHA VINESSA FOSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
136 N 10TH ST APT 704, LYONS, GA 30436-7294
(904) 832-5415
Mailing address
136 N 10TH ST APT 704, LYONS, GA 30436-7294
(904) 832-5415
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
05/09/2022
Last updated
05/09/2022
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