JASON SHALLOW

CHESTERFIELD, MI
NPI1396096327
Former NameFLORA FRANCES JOHNSON
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: MI  5501010038)
Enumeration Date2012-10-01
Last Update Date2018-04-06
Business Address
JASON SHALLOW MPT
50912 GRATIOT AVE
CHESTERFIELD, MI 48051-3134
Phone number: 586-200-6603
Mailing Address
JASON SHALLOW MPT
600 OAKMONT LN STE 600C
WESTMONT, IL 60559-5548
Phone number: 630-575-6200