Individual
SHAMORIA NACOLE PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1300 MELODY LN, VALDOSTA, GA 31601-7540
(229) 251-7296
Mailing address
1300 MELODY LN, VALDOSTA, GA 31601-7540
(229) 251-7296
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
07/28/2021
Last updated
07/28/2021
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