Individual
MRS. SHAKIRA L BANNISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
16405 NORTHCROSS DR, HUNTERSVILLE, NC 28078-5091
(800) 557-9535
Mailing address
3975 BETHANIA LOT DR APT 303, WINSTON SALEM, NC 27106-1772
(336) 923-5432
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
12569
NC
Other
Enumeration date
05/13/2012
Last updated
05/13/2012
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