Individual
SHELLY R KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4045 W ROYAL DR, TRAVERSE CITY, MI 49684-8965
(231) 935-0900
Mailing address
4045 W ROYAL DR, TRAVERSE CITY, MI 49684-8965
(231) 935-0900
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502001368
MI
Other
Enumeration date
08/13/2010
Last updated
08/13/2010
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