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Individual

SHANA LYNN RADOMSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MPT, DO

Contact information

Practice address
5900 BYRON CENTER AVE SW, WYOMING, MI 49519-9606
(616) 252-5790
Mailing address
1091 BIELBY ST, WATERFORD, MI 48328-1301

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
2022-02097
NC
2084N0400X
Neurology Physician
Primary
5101023264
MI

Other

Enumeration date
06/06/2017
Last updated
04/25/2024
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