Blaine, Shannon

Blaine, Shannon is an individual health care provider with primary practice located at 103 Parkhurst Street , Pontiac MI 48342. She recently has only one registered license in Technologists, Technicians & Other Technical Service Providers / Technician, Other, which is considered as her primary health care specialty. Blaine, Shannon can be contacted via phone (248) 425-5053.

Contact Information

Primary practice address
103 Parkhurst Street Pontiac MI 48342
Phone: (248) 425-5053
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Technician, Other 247200000X

Profile Details

NPI number 1134672868
LBN Legal business name Blaine, Shannon
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 29th, 2016
Last updated Jul 29th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers