Individual
SHANON MARIE RODERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CST
Contact information
Practice address
4700 WATERS AVE, SAVANNAH, GA 31404-6220
(912) 350-6000
Mailing address
4700 WATERS AVE, SAVANNAH, GA 31404-6220
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
—
—
246ZS0410X
Surgical Technologist
Primary
—
—
Other
Enumeration date
05/01/2020
Last updated
05/17/2022
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