Individual
KOSTYANTYN SHKILNYY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
48254 ELLINGTON DRIVE, MACOMB TOWNSHIP, MI 48044
(586) 909-0891
Mailing address
48254 ELLINGTON DR, MACOMB, MI 48044-2279
(586) 909-0891
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501000299
MI
Other
Enumeration date
04/11/2013
Last updated
04/11/2013
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