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General NPI Number Information
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NPI Number | 1124107248
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Entity Type | Organization
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Legal Business Name | THORNAPPLE TOWNSHIP
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 06/28/2012
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Provider Practice Location Address
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Address Line | 128 HIGH STREET
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City | MIDDLEVILLE
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State | MI
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Zip | 49333-0459
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Country | US
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Telephone | 269-795-3350
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Fax | 269-795-7051
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Provider Business Mailing Address
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Address Line | 128 HIGH STREET PO BOX 459
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City | MIDDLEVILLE
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State | MI
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Zip | 49333-0459
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Country | US
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Telephone | 269-795-3350
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Fax | 269-795-7051
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Authorized Official
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Title or Position | TOWNSHIP TREASURER
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Name | MS. DEBRA KAVALUSKIS-BUCKOWING
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Credential |
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Telephone | 269-795-7202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 081004
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License Number State | MI
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