Individual
SHANTANECE HARMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
PO BOX 2164, GLEN BURNIE, MD 21060-2164
(667) 305-5312
Mailing address
PO BOX 2164, GLEN BURNIE, MD 21060-2164
(667) 305-5312
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
—
MD
225000000X
Orthotic Fitter
—
MD
335E00000X
Prosthetic/Orthotic Supplier
Primary
SXOYKTFQGH
MD
Other
Enumeration date
12/09/2024
Last updated
12/09/2024
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