Individual
LA'SHONE NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
17160 130TH AVE, NUNICA, MI 49448-9450
(616) 726-5150
Mailing address
17160 130TH AVE, NUNICA, MI 49448-9450
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/02/2021
Last updated
07/02/2021
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