Individual
MS. SHANTONIA MARIA WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MLS
Contact information
Practice address
11935 ABERCORN ST, SAVANNAH, GA 31419-1918
(912) 478-4636
Mailing address
3721 SALEM CHAPEL DR, LITHONIA, GA 30038-4837
(678) 979-6538
Taxonomy
Speciality
Code
Description
License number
State
246QM0706X
Medical Technologist
—
GA
246QM0706X
Medical Technologist
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
GA
Other
Enumeration date
11/19/2024
Last updated
11/25/2024
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