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General NPI Number Information
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NPI Number | 1811194707
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Entity Type | Individual
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Provider Name | DOREEN MARIE HAZEL HART L.M.T, CST
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Gender | Female
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Dates
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Enumeration Date | 07/02/2007
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Last Update Date | 10/03/2013
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Provider Practice Location Address
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Address Line | 15040 21 MILE RD
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City | MARSHALL
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State | MI
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Zip | 49068-8108
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Country | US
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Telephone | 269-986-1789
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Fax | 269-781-1979
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Provider Business Mailing Address
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Address Line | 15040 21 MILE RD
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City | MARSHALL
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State | MI
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Zip | 49068-8108
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Country | US
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Telephone | 269-986-1789
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Fax | 269-781-1979
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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 | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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