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Individual

LORA LEA HOLLINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5300 PATTERSON AVE SE, GRAND RAPIDS, MI 49512-5663
(616) 222-5601
Mailing address
9204 E 128TH ST, SAND LAKE, MI 49343-9602
(616) 824-7663

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703079183
MI

Other

Enumeration date
03/13/2019
Last updated
03/13/2019
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