Individual
MR. MATTHEW RYAN LANTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12048 JAMES ST, HOLLAND, MI 49424-9661
(616) 396-0623
(616) 396-3391
Mailing address
1180 MATT URBAN DR APT 507, HOLLAND, MI 49423-9767
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401012526
MI
Other
Enumeration date
09/12/2011
Last updated
09/12/2011
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