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SHANNA E. AVILA PA

>> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1639418874

Individual Registrant:
 SHANNA E. AVILA PA
Gender: F
Not Sole Proprietor

Location and contact information for practice:
1107 MEMORIAL DR SUITE 201 DALTON, GA 30720-8668 US
Tel: 706-277-7311  Fax: 706-272-3512

Contact information for business:
1107 MEMORIAL DR SUITE 201 DALTON, GA 30720-8668 US
Tel: 706-277-7311  Fax: 706-272-3512

Registration Information:
NPI: 1639418874
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
TN2254

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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