Individual
STACY SHATTUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4512 N SAGINAW RD APT 812, MIDLAND, MI 48640-2357
(989) 620-6875
Mailing address
4512 N SAGINAW RD APT 812, MIDLAND, MI 48640-2357
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
08/25/2015
Last updated
08/25/2015
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