Individual
PATRICK RYAN PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
1215 FULTON ST E, GRAND RAPIDS, MI 49503-3849
(616) 742-0351
Mailing address
102 PERRINE PL NW, GRAND RAPIDS, MI 49534-8719
(616) 706-2155
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703120713
MI
Other
Enumeration date
03/07/2019
Last updated
03/07/2019
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