Individual
MRS. SHANDRA R PETTWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1709 LIBERTY ST N, CANTON, MI 48188-8002
(734) 210-2507
Mailing address
1709 LIBERTY ST N, CANTON, MI 48188-8002
(734) 210-2507
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
07/11/2024
Last updated
05/03/2025
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