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1154896827
LISA MARIE SHIMP
GRAND RAPIDS, MI
NPI
1154896827
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: MI 5202007926)
Enumeration Date
2018-10-09
Last Update Date
2018-10-09
Business Address
LISA MARIE SHIMP COTA/L
111 LAKESIDE DR NE
GRAND RAPIDS, MI 49503-3811
Phone number: 616-588-1645
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Mailing Address
LISA MARIE SHIMP COTA/L
9262 160TH AVE
WEST OLIVE, MI 49460-9193
Phone number: 616-990-0970
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