Individual
PATRICIA MOTTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2627 E BELTLINE AVE SE, STE 210, GRAND RAPIDS, MI 49546-5975
(616) 285-5100
Mailing address
5100 LITTLE PAW PAW LAKE RD, 142, COLOMA, MI 49038-9562
(269) 468-3626
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703089252
MI
Other
Enumeration date
01/08/2017
Last updated
10/16/2018
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