Individual
MR. PATRICK LAMAR SHIELDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CNA
Contact information
Practice address
1492 E BELTLINE AVE SE, GRAND RAPIDS, MI 49506-4336
(231) 730-2435
Mailing address
1492 E BELTLINE AVE SE, GRAND RAPIDS, MI 49506-4336
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
432676488260
MI
Other
Enumeration date
02/22/2017
Last updated
02/22/2017
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