Individual
MRS. SHANNAN MARIE STORCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
REGISTERD NURSE
Contact information
Practice address
647 LINCOLN ST, WYANDOTTE, MI 48192-2643
(313) 409-1163
Mailing address
647 LINCOLN ST, WYANDOTTE, MI 48192-2643
(313) 409-1163
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704202159
MI
Other
Enumeration date
10/18/2015
Last updated
10/18/2015
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