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1124714688
SHANNON ANTISHIN
DETROIT, MI
NPI
1124714688
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Former Name
SHANNON HOOD
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2023-04-17
Last Update Date
2023-06-07
Business Address
SHANNON ANTISHIN DO
2799 W GRAND BLVD
DETROIT, MI 48202-2608
Phone number: 313-916-1601
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Mailing Address
SHANNON ANTISHIN DO
2799 W GRAND BLVD
DETROIT, MI 48202-2608
Phone number:
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