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1952723892
OLIVIA LEE RIVERA
GRAND RAPIDS, MI
NPI
1952723892
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Former Name
OLIVIA LEE JOHNSON
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MI 5601006892)
Enumeration Date
2014-01-13
Last Update Date
2020-06-29
Business Address
Ms. OLIVIA LEE RIVERA PA-C
25 MICHIGAN ST NE STE 6100
GRAND RAPIDS, MI 49503-2561
Phone number: 616-267-7900
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Mailing Address
Ms. OLIVIA LEE RIVERA PA-C
1468 FAIRWOOD CT SE
CALEDONIA, MI 49316-9738
Phone number: 616-204-7475
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