Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath |
NPI | 1649571670 |
---|---|
Provider Name | Holly Nicole Lignell |
First Address | Saint Joseph, MI 49085-2437 |
Second Address | Saint Joseph, MI 49085-2437 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2010 |
Last Update Date | 08/11/2010 |