Healthcare Provider Details

I. General information

NPI: 1922136183
Provider Name (Legal Business Name): SEKIM RESOURCES MICHIGAN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 05/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21616 LAKE ST
CASSOPOLIS MI
49031-9321
US

IV. Provider business mailing address

21616 LAKE ST
CASSOPOLIS MI
49031-9321
US

V. Phone/Fax

Practice location:
  • Phone: 269-445-8854
  • Fax:
Mailing address:
  • Phone: 269-445-8854
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number3501004495
License Number StateMI

VIII. Authorized Official

Name: JAMES M. SEEDORF
Title or Position: OWNER
Credential: BC-HIS
Phone: 269-445-8845