Individual
SHANNAN KLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
724 W CENTRE AVE STE 105, PORTAGE, MI 49024-6306
(269) 327-3700
(269) 323-0229
Mailing address
5084 LOVERS LN, PORTAGE, MI 49002-1557
(269) 327-3700
(269) 323-0229
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
4301068834
MI
Other
Enumeration date
12/30/2013
Last updated
12/30/2013
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