Most Relevant Information
Provider Data
| NPI Number: | 1003377276 |
| Provider Name: | SHONTASIA MATTHEWS |
| Entity Type: | Individual |
| Taxonomy Code: | 247200000X |
| Specialty: | Technician, Other |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/28/2019 |
| Last Updated: | 04/29/2024 |
Provider Practice Location
1175 WESLEY AVE
MUSKEGON
MI
494422100
Practice Location Phone/Fax
| Phone: | 2312202344 |
| Fax: |
Provider Mailing Location
376 E APPLE AVE
MUSKEGON
MI
494423466
Provider Mailing Phone/Fax
| Phone: | 2317241111 |
| Fax: | 2317244188 |