Individual
MRS. SHANTIA LYLE KOGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4320 JUDITH LN SW, HUNTSVILLE, AL 35805-3363
(256) 837-1730
Mailing address
110 THORNLEY CT, MADISON, AL 35756-4077
(205) 243-9569
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2383
AL
Other
Enumeration date
01/26/2016
Last updated
01/26/2016
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