Most Relevant Information
Provider Data
| NPI Number: | 1003525643 |
| Provider Name: | LATISHA HOLLIMAN |
| Entity Type: | Individual |
| Taxonomy Code: | 343900000X |
| Specialty: | Non-emergency Medical Transport (VAN) |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/22/2022 |
| Last Updated: | 11/22/2022 |
Provider Practice Location
5328 SHOREHAM PL SE
GRAND RAPIDS
MI
495086337
Practice Location Phone/Fax
| Phone: | 6162146168 |
| Fax: |
Provider Mailing Location
5328 SHOREHAM PL SE
GRAND RAPIDS
MI
495086337
Provider Mailing Phone/Fax
| Phone: | 6162146168 |
| Fax: |