Individual
MR. SHANKAR NARAYAN VISWANATHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
607 42ND ST E, TIFTON, GA 31794-1549
(229) 392-3663
(229) 387-0568
Mailing address
607 42ND ST E, TIFTON, GA 31794-1549
(229) 392-3663
(229) 387-0568
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP004574
GA
Other
Enumeration date
05/03/2007
Last updated
07/08/2007
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