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Individual

JUSTIN MERRITT SHAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3079 28TH ST SE, KENTWOOD, MI 49512-1667
(616) 942-0795
(616) 942-0901
Mailing address
1802 GALLOWAY ST, EAU CLAIRE, WI 54703-3467
(715) 831-8966
(715) 831-8968

Taxonomy

Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
3501005725
MI

Other

Enumeration date
11/15/2012
Last updated
11/15/2012
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