Individual
LASHALA SIVLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5632 ALTEN ST, PORTAGE, MI 49024-9502
(269) 217-9401
Mailing address
5632 ALTEN ST, PORTAGE, MI 49024-9502
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704371591
MI
Other
Enumeration date
10/11/2023
Last updated
10/11/2023
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