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General NPI Number Information
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NPI Number | 1588961411
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Entity Type | Individual
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Provider Name | KAREN SUE SHANNON-WILSON MSOTRL
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Gender | Female
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Dates
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Enumeration Date | 02/11/2011
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Last Update Date | 02/11/2011
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Provider Practice Location Address
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Address Line | 35746 HARPER TOTA REHAB SERVICES, INC.
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City | CLINTON TWP.
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State | MI
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Zip | 48035
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Country | US
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Telephone | 586-791-9203
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Fax | 586-791-9204
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Provider Business Mailing Address
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Address Line | 3837 HARSHBARGER RD
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City | JACKSON
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State | MI
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Zip | 49203-3556
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Country | US
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Telephone | 517-581-0071
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 5201003337
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License Number State | MI
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