Individual
MRS. SHANNON ROUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
721 N CENTER DR NW, WALKER, MI 49544-8215
(616) 647-2590
(616) 647-2689
Mailing address
721 N CENTER DR NW, WALKER, MI 49544-8215
(616) 647-2590
(616) 647-2689
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
514359
OK
Other
Enumeration date
11/10/2014
Last updated
11/10/2014
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