Individual
SHANTRELL HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1151 W 29TH ST, JACKSONVILLE, FL 32209-4015
(904) 418-4781
(904) 485-8167
Mailing address
PO BOX 12777, JACKSONVILLE, FL 32209-0777
(904) 418-4781
(904) 485-8167
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
08/24/2017
Last updated
08/24/2017
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