Individual
SHANNON HUDDLESTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1385 E EMPIRE AVE, BENTON HARBOR, MI 49022-2037
(269) 925-0033
Mailing address
848 OGDEN AVE, BENTON HARBOR, MI 49022-5135
(269) 759-4149
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
44985
MI
Other
Enumeration date
03/04/2019
Last updated
03/04/2019
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