MEDICARE: SANDRA HOWE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	247200000X	Other Technician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	247200000X	OTHER	MI	TECHNICIAN

General Provider Information

NPI Number	:	1730639303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA HOWE

Provider Business Mailing Address
First Line	:	27002 S PRENTISS BAY RD
Second Line	:
City	:	GOETZVILLE
State	:	MI
Zip	:	49736-9340
Country	:	US
Telephone Number	:	802-299-9650
Fax Number	:

Provider Business Practice Location Address
First Line	:	27002 S PRENTISS BAY RD
Second Line	:
City	:	GOETZVILLE
State	:	MI
Zip	:	49736-9340
Country	:	US
Telephone Number	:	802-299-9650
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/07/2016
Last Update Date	:	10/07/2016

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