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Organization
ROCK STEADY BOXING MID MICHIGAN
Active
Organization
ROCK STEADY BOXING MID MICHIGAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY LYNNE HANNAH (OWNER/HEAD COACH)
(989) 486-1154
Entity
Organization
Contact information
Practice address
1914 S SAGINAW RD APT 408, MIDLAND, MI 48640-6808
(989) 486-1154
Mailing address
1914 S SAGINAW RD APT 408, MIDLAND, MI 48640-6808
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
NULL
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
06/01/2017
Last updated
06/01/2017
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