Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 5201000706 | MI |
NPI | 1275650574 |
---|---|
Provider Name | Mr. Loren David Nowc |
First Address | Sterling Heights, MI 48312-5228 |
Second Address | Macomb, MI 48044-5742 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2007 |
Last Update Date | 08/07/2007 |