Individual
SHAUNTEL JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
921 MAINSTREET LAKE DR, STONE MOUNTAIN, GA 30088-2345
(404) 769-7651
Mailing address
921 MAINSTREET LAKE DR, STONE MOUNTAIN, GA 30088-2345
(404) 769-7651
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
11151
CA
225200000X
Physical Therapy Assistant
Primary
PTA003158
GA
Other
Enumeration date
12/26/2016
Last updated
12/26/2016
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