Individual
JEREE SHANTE BANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
682 LAVA TRL, FAYETTEVILLE, NC 28311-1920
(910) 676-8158
Mailing address
682 LAVA TRL, FAYETTEVILLE, NC 28311-1920
(910) 676-8158
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
—
—
Other
Enumeration date
07/19/2018
Last updated
07/19/2018
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