Individual
KEESHA SHANKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1423 W CENTRE AVE, PORTAGE, MI 49024-5323
(269) 323-4449
Mailing address
520 S PLATT ST, OTSEGO, MI 49078-1440
(262) 914-4098
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
5501017373
MI
Other
Enumeration date
09/04/2015
Last updated
09/04/2015
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