Provider Demographics
NPI:1235997339
Name:FLETCHER-FRANKLIN, SHANTERIA (SPECIALIST)
Entity Type:Individual
Prefix:
First Name:SHANTERIA
Middle Name:
Last Name:FLETCHER-FRANKLIN
Suffix:
Gender:F
Credentials:SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3440 BOULDER PARK DR SW APT 402
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-1811
Mailing Address - Country:US
Mailing Address - Phone:404-781-1053
Mailing Address - Fax:
Practice Address - Street 1:568 POOLE PL SW SUITE G
Practice Address - Street 2:ROOM 120
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30310
Practice Address - Country:US
Practice Address - Phone:404-781-1053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACO1389011744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management