Individual
CASSANDRA SHIELDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
275 CARPENTER DR, SUITE 350, ATLANTA, GA 30328-4928
(404) 549-3936
Mailing address
110 WALTER WAY, 1693, STOCKBRIDGE, GA 30281-9533
(404) 587-4412
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
CO084506
GA
1744P3200X
Prosthetics Case Management
RC75004
SC
Other
Enumeration date
09/15/2015
Last updated
06/08/2016
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