Individual
SHANE DENIS O'BRIEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
201 1/2 E GRAND RIVER AVE, SUITE 19, EAST LANSING, MI 48823-4323
(517) 203-1113
Mailing address
1138 LONG LAKE DR, BRIGHTON, MI 48114-9641
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
07/26/2012
Last updated
07/26/2012
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