Individual
SANJEEV THAMMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MHS,OTR
Contact information
Practice address
1994 TALL PINES DR SE, GRAND RAPIDS, MI 49546-7922
(616) 856-0102
Mailing address
1994 TALL PINES DR SE, GRAND RAPIDS, MI 49546-7922
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201002120
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5201002120
STATE OF MICHIGAN
MI
Enumeration date
01/21/2008
Last updated
11/12/2014
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