Individual
SHANTASIA WIMBERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
5070 WARM SPRINGS RD, APT 106, COLUMBUS, GA 31909-4172
(404) 422-8584
Mailing address
5070 WARM SPRINGS RD, APT 106, COLUMBUS, GA 31909-4172
(404) 422-8584
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
10/07/2014
Last updated
04/14/2015
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