Individual
SHANNON VANESTINE BANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1908 1ST ST, SANDUSKY, OH 44870-3904
(419) 307-0176
Mailing address
1908 1ST ST, SANDUSKY, OH 44870-3904
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
—
Other
Enumeration date
11/10/2016
Last updated
11/10/2016
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