Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 4301074548 | MI |
NPI | 1134131683 |
---|---|
Provider Name | Rick L Holland |
First Address | Lansing, MI 48909-8016 |
Second Address | Zeeland, MI 49464 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2006 |
Last Update Date | 21/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H00132 | (02) | MI |
P0003407 | RAILROAD MEDICARE (01) | MI |