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General NPI Number Information
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NPI Number | 1154391670
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Entity Type | Individual
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Provider Name | THOMAS G SPOELMAN R.PH.
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Gender | Male
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Dates
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Enumeration Date | 01/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1116 ROBBINS RD
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City | GRAND HAVEN
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State | MI
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Zip | 49417-2740
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Country | US
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Telephone | 616-846-7180
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Fax |
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Provider Business Mailing Address
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Address Line | 18936 PINEY POINT DR
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City | SPRING LAKE
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State | MI
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Zip | 49456-9229
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Country | US
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Telephone | 616-847-5004
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5302410978
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License Number State | MI
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