Organization
LAKESHORE PROFESSIONAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANYA THOMAS (OWNER)
(231) 571-4179
Entity
Organization
Contact information
Practice address
3375 MERRIAM ST, SUITE 202, MUSKEGON, MI 49444-3173
(231) 571-4179
(231) 720-0501
Mailing address
3375 MERRIAM ST, SUITE 202, MUSKEGON, MI 49444-3173
(231) 571-4179
(231) 720-0501
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
11/26/2012
Last updated
11/26/2012
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