Individual
BARBARA SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5757 WHITMORE LAKE RD, STE 900, BRIGHTON, MI 48116-1962
(810) 220-5793
(810) 220-5805
Mailing address
5757 WHITMORE LAKE RD, STE 900, BRIGHTON, MI 48116-1962
(810) 220-5793
(810) 220-5805
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501002932
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H25066
BCBS
MI
01
—
741774
LICENSE NUMBER
MI
Enumeration date
01/30/2007
Last updated
03/14/2017
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