Individual
SHAVON LAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1323 SPRUCE ST, CHARLOTTE, NC 28203-4670
(980) 202-9687
Mailing address
1323 SPRUCE ST, CHARLOTTE, NC 28203-4670
(980) 202-9687
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
273719
NC
Other
Enumeration date
01/14/2016
Last updated
01/29/2016
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