Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | MI |
NPI | 1073642229 |
---|---|
Provider Name | Thomas Hein |
First Address | Milford, MI 48381-1820 |
Second Address | Milford, MI 48381-1820 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2007 |
Last Update Date | 08/07/2007 |