MEDICARE: SHANNON MURLENE SAUNDERS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	7501001148	MI

General Provider Information

NPI Number	:	1700248127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANNON MURLENE SAUNDERS

Provider Business Mailing Address
First Line	:	16993 THIRD ST
Second Line	:
City	:	COPEMISH
State	:	MI
Zip	:	49625
Country	:	US
Telephone Number	:	231-871-0361
Fax Number	:

Provider Business Practice Location Address
First Line	:	3337 S AIRPORT RD W STE 2
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49684-7927
Country	:	US
Telephone Number	:	231-922-8100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2016
Last Update Date	:	03/24/2016

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Directions to “ SHANNON MURLENE SAUNDERS ” Practice Location

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