# ROCK STEADY BOXING MID MICHIGAN

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104354349
- **Authorized official:** STACEY LYNNE HANNAH (OWNER/HEAD COACH)
- **Authorized official phone:** (989) 486-1154

## Contact information

- **Practice address:** 1914 S SAGINAW RD APT 408, MIDLAND, MI 48640-6808
- **Practice address phone:** (989) 486-1154
- **Mailing address:** 1914 S SAGINAW RD APT 408, MIDLAND, MI 48640-6808

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225400000X | Rehabilitation Practitioner | — | NULL | Yes |
| 225400000X | Rehabilitation Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 06/01/2017
- **Last updated:** 06/01/2017