Individual
SHAQUELA L SANFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
301 N SAINT MARKS AVE, CHATTANOOGA, TN 37411-3435
(256) 348-9295
Mailing address
301 N SAINT MARKS AVE, CHATTANOOGA, TN 37411-3435
(256) 348-9295
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
—
TN
224P00000X
Prosthetist
Primary
—
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1744P3200X
—
TN
Enumeration date
08/25/2020
Last updated
12/02/2020
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