Individual
LACY J HAWLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
825 LEONARD ST NE, GRAND RAPIDS, MI 49503-1177
(616) 200-4441
Mailing address
825 LEONARD ST NE, GRAND RAPIDS, MI 49503-1177
(616) 200-4441
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704279918
MI
Other
Enumeration date
06/13/2022
Last updated
06/13/2022
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