Shannon Gregory
Massage Therapist in Lansing, MI. Individual provider (NPI-1).
NPI number1477190965
StatusActive
Last updated in NPPESDec 4, 2019
Details
- NPI
- 1477190965
- Entity type
- Individual (NPI-1)
- Name
- Shannon Gregory
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Dec 4, 2019
- Last updated
- Dec 4, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225700000X | Massage Therapist | 7501011702 | MI | Yes |
Practice location
526 S Creyts RdLansing, MI 48917-8263
Phone 727-385-7609
Mailing address
126 E Mason StLansing, MI 48910-4521
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