Individual
MISS SHANITA ROSHAWN SHUFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MEDICAL WIG PROVIDER
Contact information
Practice address
125 N TRADO ST SUITE D, STATESVILLE, NC 28677
(828) 571-8564
Mailing address
PO BOX 6602 STATESVILLE NC 28687, STATESVILLE, NC 28687
(980) 316-8921
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
NC
Other
Enumeration date
11/26/2024
Last updated
11/26/2024
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