Individual
SHANA CROUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1735 WOLF LAKE RD, GRASS LAKE, MI 49240-9420
(517) 612-8194
Mailing address
1735 WOLF LAKE RD, GRASS LAKE, MI 49240-9420
(517) 612-8194
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
09/19/2016
Last updated
09/19/2016
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