Individual
SHANNON RAE KRYLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1060 W SILVERBELL RD, LAKE ORION, MI 48359-1327
(248) 845-4082
Mailing address
48 GINGELL CT, PONTIAC, MI 48342
(248) 421-7253
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
3501002943
MI
Other
Enumeration date
04/08/2016
Last updated
04/08/2016
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