Individual
LETHECIA D HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
21 MICHIGAN NE SUITE 525, GRAND RAPIDS, MI 49503
(616) 391-3775
Mailing address
3948 NORTH ROSEBUD COURT SE, KENTWOOD, MI 49512
(616) 656-3410
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301083856
MI
Other
Enumeration date
05/03/2007
Last updated
07/08/2007
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