Provider Demographics
NPI:1801171863
Name:HOLLMAN, LESLIE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:
Last Name:HOLLMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:
Other - Last Name:LUKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1771 HOLTON RD
Mailing Address - Street 2:
Mailing Address - City:NORTH MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49445-1452
Mailing Address - Country:US
Mailing Address - Phone:231-744-1391
Mailing Address - Fax:
Practice Address - Street 1:1771 HOLTON RD
Practice Address - Street 2:
Practice Address - City:NORTH MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49445-1452
Practice Address - Country:US
Practice Address - Phone:231-547-1356
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-20
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302038162183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist