Provider Demographics
NPI:1316961196
Name:ROZNAY, SHANNON K (DC)
Entity type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:K
Last Name:ROZNAY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:SHANNON
Other - Middle Name:K
Other - Last Name:DICKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:6901 STATE RD
Mailing Address - Street 2:STE D
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-8930
Mailing Address - Country:US
Mailing Address - Phone:734-470-6766
Mailing Address - Fax:
Practice Address - Street 1:6901 STATE RD
Practice Address - Street 2:STE D
Practice Address - City:SALINE
Practice Address - State:MI
Practice Address - Zip Code:48176-8930
Practice Address - Country:US
Practice Address - Phone:734-470-6766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MISD008957111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP36370002Medicare PIN
MIU99701Medicare UPIN