Individual
SHAWNTA WARREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10907 TANEY DR, FREDERICKSBURG, VA 22407-2561
(540) 388-2821
(540) 412-1195
Mailing address
10907 TANEY DR, FREDERICKSBURG, VA 22407-2561
(540) 388-2821
(540) 412-1195
Taxonomy
Speciality
Code
Description
License number
State
171WV0202X
Vehicle Modifications Contractor
Primary
T63456150
VA
Other
Enumeration date
11/17/2015
Last updated
11/17/2015
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