Individual
SHANE MICHAEL COUSINEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
997 N CENTER AVE, GAYLORD, MI 49735-9375
(989) 732-2225
(989) 731-6776
Mailing address
997 N CENTER AVE, GAYLORD, MI 49735-9375
(989) 732-2225
(989) 731-6776
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
SC008123
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4259114
—
MI
Enumeration date
07/01/2006
Last updated
05/19/2011
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