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Individual

SHARONICA SHANTA KING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
177 N HIGHLAND ST, MEMPHIS, TN 38111-4747
(901) 325-9248
Mailing address
177 N HIGHLAND ST, MEMPHIS, TN 38111-4747
(901) 325-4003

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
6743
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0000006743
TN
Enumeration date
06/16/2022
Last updated
06/16/2022
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