Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 5501008972 | MI |
NPI | 1053813238 |
---|---|
Provider Name | Mrs. Jennifer Joan Shifferd |
First Address | Ann Arbor, MI 48109-5000 |
Second Address | Ann Arbor, MI 48109-5000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2018 |
Last Update Date | 05/03/2018 |