Individual provider · Type 1 NPI
Shonda King, TRICHOLOGY
Clinic/Center · Midway, GA
NPI number
1255808515
Active
Practice location
150 Butler St Ste D5-D7
Midway, GA 31320-4575
Mailing address
PO Box 641
Midway, GA 31320-0641
Other practice locations
- 150 Butler St Ste D-5D7, Midway, GA 31320-4575 · (912) 463-2883
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinic/Center Primary | 261Q00000X | None listed |
Clinic/Center: A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
About NPI 1255808515
Shonda King, TRICHOLOGY's National Provider Identifier is 1255808515, issued on Oct 25, 2018. The primary taxonomy on file is Clinic/Center (261Q00000X), and the practice location is in Midway, GA. The record was last updated on Oct 25, 2018.