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NPI Profile for SHANTREZE D ANDERSON in LAGRANGE, GA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X |
| NPI # | 1306202007 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 01/11/2016 | |
| Last updated | 01/11/2016 - About 10 years ago | |
| Sole proprietor 1 | No | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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SHANTREZE D ANDERSON
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SHANTREZE D ANDERSON