Individual
SHANNON K STANEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1736 W MICHIGAN AVE, WESTWOOD MALL, JACKSON, MI 49202-4005
(517) 789-7131
(517) 789-7111
Mailing address
947 S CEDAR ST, APT #7, MASON, MI 48854-2069
(517) 896-0115
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004252
MI
Other
Enumeration date
12/19/2006
Last updated
07/08/2007
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