Individual
SHONN GREENGRASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1709 MOON ST NE, ALBUQUERQUE, NM 87112-3935
(505) 271-0329
Mailing address
120 CORNELL DR SE, ALBUQUERQUE, NM 87106-3561
(505) 639-8093
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/15/2024
Last updated
11/15/2024
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