Individual
THOMAS SACKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7855 CURRIER DR, PORTAGE, MI 49002-4314
(269) 323-7748
Mailing address
5954 WATERPOINTE, KALAMAZOO, MI 49009-6812
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
5502003137
MI
Other
Enumeration date
04/23/2015
Last updated
04/23/2015
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