Healthcare Provider Details

I. General information

NPI: 1689597551
Provider Name (Legal Business Name): SHANNON LABONTE LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 BURTON CT
GRAYLING MI
49738-1700
US

IV. Provider business mailing address

313 SILVERHILL DR
HOUGHTON LAKE MI
48629-9155
US

V. Phone/Fax

Practice location:
  • Phone: 989-387-8351
  • Fax:
Mailing address:
  • Phone: 989-387-8351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License Number7501008943
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: