Individual
SHONTA MONIQUE HOUSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, PTA
Contact information
Practice address
110 LINK ST APT 3L, HINESVILLE, GA 31313-4430
(478) 335-7488
Mailing address
110 LINK ST APT 3L, HINESVILLE, GA 31313-4430
(478) 335-7488
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
PTA004442
GA
2255A2300X
Athletic Trainer
Primary
AT002562
GA
Other
Enumeration date
08/13/2020
Last updated
08/13/2020
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