Individual
PAVEL TOMENKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1899 DRACKA RD, TRAVERSE CITY, MI 49685-8818
(231) 946-2999
Mailing address
111 W FERRY ST, BERRIEN SPRINGS, MI 49103-1154
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
01/18/2019
Last updated
01/18/2019
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