Individual
LATESA THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2450 VAN OMMEN DR, HOLLAND, MI 49424-8085
(269) 261-5178
Mailing address
2450 VAN OMMEN DR, HOLLAND, MI 49424-8085
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/02/2022
Last updated
11/02/2022
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