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1174276026
SHANNON WALLS
FORT BENNING, GA
NPI
1174276026
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
125J00000X Dental Therapist
Enumeration Date
2022-02-01
Last Update Date
2022-07-21
Business Address
SHANNON WALLS
3255 11 AIRBORNE DIVISION ROAD
FORT BENNING, GA 31801
Phone number: 706-544-9071
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Mailing Address
SHANNON WALLS
3255 11 AIRBORNE DIVISION ROAD
FORT BENNING, GA 31801
Phone number: 706-544-9071
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