Individual
STANLEY SHROADS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
705 S MAIN ST, SUITE 220, PLYMOUTH, MI 48170-2089
(773) 549-5294
Mailing address
705 S MAIN ST, SUITE 220, PLYMOUTH, MI 48170-2089
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32002078A
IN
Other
Enumeration date
12/20/2011
Last updated
12/20/2011
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