Individual
SHANNA WALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4845 WHITE PINE DRIVE, MANISTEE, MI 49660
(231) 510-5221
Mailing address
4845 WHITE PINE DR, 4845 WHITE PINE DR, MANISTEE, MI 49660
(231) 510-5221
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
04/12/2024
Last updated
04/12/2024
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