Individual
THOMAS PATRICK HARRISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
1215 FULTON ST E, GRAND RAPIDS, MI 49503-3849
(616) 742-0351
(616) 742-0370
Mailing address
827 137TH AVE, WAYLAND, MI 49348-9705
(616) 322-9574
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703098125
MI
Other
Enumeration date
03/07/2019
Last updated
03/07/2019
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