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Individual

MRS. GINA SHEALEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
139 MOUNT ZION RD SW, ATLANTA, GA 30354-2370
(678) 596-3276
Mailing address
5375 KINGS HWY, DOUGLASVILLE, GA 30135-5415
(678) 596-3276

Taxonomy

Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
052772082
GA

Other

Enumeration date
12/09/2020
Last updated
12/09/2020
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