Shantise Michelle LLC
NPI #1639789340 in Maplewood, New Jersey
Provider Information
- NPI Number
- 1639789340
- Entity Type
- Organization
- Organization Name
- Shantise Michelle LLC
- Primary Specialty
- Prosthetic/Orthotic Supplier
- Enumeration Date
- Aug 6, 2020
- Last Updated
- Feb 9, 2024
Practice Location
- Address
- 2040 MILLBURN AVE STE 305
- City
- Maplewood
- State
- New Jersey
- ZIP Code
- 07040-3716
- Phone
- (973) 901-3640
Authorized Official
- Name
- MS. SHANTISE PARKER
- Title
- OWNER
- Phone
- (973) 901-3640
Specialties & Taxonomy Codes
| Specialty |
|---|
| Prosthetic/Orthotic Supplier |
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