Individual
JENNIFER ELIZABETH SHOUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1521 GULL RD, KALAMAZOO, MI 49048-1640
(269) 226-5992
(269) 226-5770
Mailing address
9665 CANDYTUFT, GALESBURG, MI 49053-7724
(269) 665-4551
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501012398
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1568416311
—
MI
Enumeration date
04/03/2018
Last updated
04/03/2018
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