Individual
MR. NORMAN LEE THEAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
TH.D, RRT
Contact information
Practice address
7949 CEDAR ST, VANDERBILT, MI 49795-5107
(989) 350-8234
Mailing address
7949 CEDAR ST, PO BOX 142, VANDERBILT, MI 49795-5107
(989) 350-8234
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
4401004366
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4401004366
RESPIRATORY CARE
MI
Enumeration date
08/30/2012
Last updated
08/30/2012
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