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1114542438
SHANITA DAVIS
LAWRENCEVILLE, GA
NPI
1114542438
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
376J00000X Homemaker
Enumeration Date
2020-06-11
Last Update Date
2020-06-11
Business Address
SHANITA DAVIS
1245 STONEY FIELD PL
LAWRENCEVILLE, GA 30043-3830
Phone number: 813-475-9970
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Mailing Address
SHANITA DAVIS
1245 STONEY FIELD PL
LAWRENCEVILLE, GA 30043-3830
Phone number: 813-475-9970
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