Individual
SHANNON NOWACZEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22101 MOROSS RD, DETROIT, MI 48236-2148
(313) 343-3744
Mailing address
23359 N COLONIAL CT, SAINT CLAIR SHORES, MI 48080-2603
(248) 396-4990
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502005028
MI
Other
Enumeration date
11/28/2025
Last updated
11/28/2025
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