Individual
ROXANNE SHOUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3930 KELLER RD, HOLT, MI 48842-1824
(517) 648-9928
Mailing address
3930 KELLER RD, HOLT, MI 48842-1824
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/10/2017
Last updated
03/10/2017
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