Shack, John Richard

Shack, John Richard is an sole proprietor health care provider with primary practice located at 713 Wilderness Dr. , Douglas MI 49406-0140. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Shack, John Richard can be contacted via phone (269) 857-8644.

Contact Information

Primary practice address
713 Wilderness Dr. Douglas MI 49406-0140
Phone: (269) 857-8644
Fax: (269) 857-8644
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 6301011374 Michigan

Profile Details

NPI number 1942478706
LBN Legal business name Shack, John Richard
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 14th, 2008
Last updated Feb 14th, 2008 - about 18 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.

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