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Individual

DAVINA SHAWNTA GRANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1008 SAND TRAP LN, MACON, GA 31220-6414
(478) 508-5677
Mailing address
8735 DUNWOODY PL, 10492, MACON, GA 31220
(478) 207-9651
(404) 856-0692

Taxonomy

Speciality
Code
Description
License number
State
246QL0900X
Laboratory Management Specialist/Technologist
Primary

Other

Enumeration date
08/16/2024
Last updated
08/28/2025
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