Provider Demographics
NPI:1093975765
Name:JAMES, SHIRLEY MAY (LMT)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:MAY
Last Name:JAMES
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 GOLDEN ASTER TRCE
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-2270
Mailing Address - Country:US
Mailing Address - Phone:770-974-4577
Mailing Address - Fax:678-574-7607
Practice Address - Street 1:202 GOLDEN ASTER TRCE
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-2270
Practice Address - Country:US
Practice Address - Phone:770-974-4577
Practice Address - Fax:678-574-7607
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA261795931OtherTAX ID