Individual
THO P THANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2360 VICKSBURG CT SE, KENTWOOD, MI 49508-6660
(616) 828-9647
Mailing address
2360 VICKSBURG CT SE, KENTWOOD, MI 49508-6660
(616) 828-9647
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
04/26/2019
Last updated
04/26/2019
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