Organization
SNAPP BACK TO HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHANTA NICOLE BROWN NP (OWNER)
(248) 252-9730
Entity
Organization
Contact information
Practice address
20905 GREENFIELD RD STE 303, SOUTHFIELD, MI 48075-5347
(248) 450-3177
Mailing address
20905 GREENFIELD RD STE 303, SOUTHFIELD, MI 48075-5347
(248) 450-3177
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/14/2022
Last updated
06/14/2022
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