Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156F00000X | Technician/Technologist |
NPI | 1154085330 |
---|---|
Provider Name | Michelle Helen Eckardt |
First Address | Rochester, MI 48306-4815 |
Second Address | Rochester, MI 48306-4815 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2021 |
Last Update Date | 25/10/2021 |