Individual
SHANNON HUIZDOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
27850 GRATIOT AVE, ROSEVILLE, MI 48066-4803
(586) 772-5876
Mailing address
27850 GRATIOT AVE, ROSEVILLE, MI 48066-4803
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501008367
MI
Other
Enumeration date
01/26/2017
Last updated
01/26/2017
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