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1013573609
SHANE GAY
COLUMBUS, GA
NPI
1013573609
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: GA LPN072762)
Enumeration Date
2019-05-20
Last Update Date
2019-05-20
Business Address
SHANE GAY
2100 COMER AVE
COLUMBUS, GA 31904-8725
Phone number: 706-596-5500
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Mailing Address
SHANE GAY
107 LINCOLN LN
LAGRANGE, GA 30240-8709
Phone number: 762-323-2901
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