Wollak, Lydia Charlene

Wollak, Lydia Charlene is an individual health care provider with primary practice located at 2814 Woodcliff Cir Se , East Grand Rapids MI 49506-3155. She recently has only one registered license in Technologists, Technicians & Other Technical Service Providers / Technician, Other, which is considered as her primary health care specialty. Wollak, Lydia Charlene can be contacted via phone (855) 832-6727.

Contact Information

Primary practice address
2814 Woodcliff Cir Se East Grand Rapids MI 49506-3155
Phone: (855) 832-6727
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Technician, Other 247200000X

Profile Details

NPI number 1972155034
LBN Legal business name Wollak, Lydia Charlene
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 9th, 2019
Last updated Jan 18th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1972155034 NPPES
Michigan MEDICAID 247200000X

Popular Providers