Individual
SHANEQUA COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6700 ROSBY AVE, FORT WORTH, TX 76123-2086
(414) 416-3339
Mailing address
6700 ROSBY AVE, FORT WORTH, TX 76123-2086
(414) 416-3339
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
C452-7959-4862-02
WI
Other
Enumeration date
04/16/2024
Last updated
04/16/2024
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