Healthcare Provider Details

I. General information

NPI: 1477986990
Provider Name (Legal Business Name): ISETT ENTERPRISES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2013
Last Update Date: 08/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 N GRATIOT AVE
MOUNT CLEMENS MI
48043-5751
US

IV. Provider business mailing address

PO BOX 313
NEW BALTIMORE MI
48047-0313
US

V. Phone/Fax

Practice location:
  • Phone: 248-390-0943
  • Fax: 586-329-1951
Mailing address:
  • Phone: 248-390-0943
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: MR. THOMAS BARCLAY ISETT
Title or Position: PRESIDENT
Credential:
Phone: 586-329-1950