Provider Demographics
NPI:1114465580
Name:HOLLAND, WILLIAM GREGORY
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:GREGORY
Last Name:HOLLAND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 PETOSKEY ST STE 5
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-2779
Mailing Address - Country:US
Mailing Address - Phone:231-330-5372
Mailing Address - Fax:
Practice Address - Street 1:616 PETOSKEY ST STE 5
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-2779
Practice Address - Country:US
Practice Address - Phone:231-330-5372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-06
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program