SearchGeorgia164W00000X

Chaunta Shannon

NPI 1831940741 · on the registry since 2024 · sole proprietor

Practice

Address
1090 Eagles Brooke Dr
Locust Grove, GA 30248
Phone
(419) 610-3721

Registry record

Primary taxonomy
164W00000X
164W00000X
Licence states on file
MS
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2024-03-28

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia