Individual
SHANNON LYNN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15131 NORTHVILLE RD, PLYMOUTH, MI 48170-2548
(734) 309-1103
Mailing address
15131 NORTHVILLE RD, PLYMOUTH, MI 48170-2548
(734) 309-1103
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501002581
MI
Other
Enumeration date
09/06/2018
Last updated
09/06/2018
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