Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 7501000717 | MI |
NPI | 1003261694 |
---|---|
Provider Name | Shantelle Marie Whalen Lehr |
First Address | Flint, MI 48507 |
Second Address | Flint, MI 48507 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2016 |
Last Update Date | 02/05/2016 |