Individual
THOMAS J HENKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
625 KENMOOR AVE SE STE 301, GRAND RAPIDS, MI 49546-2395
(616) 916-8063
Mailing address
3084 BARONS COVE DR, EDGEWOOD, KY 41017-8131
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
5101025584
MI
208D00000X
General Practice Physician
Primary
5101025584
MI
261QU0200X
Urgent Care Clinic/Center
5101025584
MI
Other
Enumeration date
05/03/2015
Last updated
03/22/2022
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