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General NPI Number Information
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NPI Number | 1922992387
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Entity Type | Individual
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Provider Name | DOMINIC ANTHONY ESSICH AUD
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Gender | Male
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Dates
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Enumeration Date | 06/09/2025
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 6850 N HAGGERTY RD
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City | CANTON
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State | MI
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Zip | 48187-3577
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Country | US
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Telephone | 734-386-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 215 UNION ST
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City | IONIA
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State | MI
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Zip | 48846-1644
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Country | US
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Telephone | 616-755-5666
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 1601001202
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License Number State | MI
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