Individual
SHANDA MATHIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
26730 NOTRE DAME ST, INKSTER, MI 48141-2530
(313) 789-8421
Mailing address
26730 NOTRE DAME ST, INKSTER, MI 48141-2530
(313) 789-8421
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
—
Other
Enumeration date
03/15/2017
Last updated
03/15/2017
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