Roche, Michael Thomas

Roche, Michael Thomas is an individual health care provider with primary practice located at 143 Bostwick Ave Ne , Grand Rapids MI 49503-3201. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as his primary health care specialty. Roche, Michael Thomas can be contacted via phone (616) 234-4260.

Contact Information

Primary practice address
143 Bostwick Ave Ne Grand Rapids MI 49503-3201
Phone: (616) 234-4260
Fax: (616) 234-4262
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X

Profile Details

NPI number 1326001777
LBN Legal business name Roche, Michael Thomas
Credentials Athletic Trainer, Certified (ATC)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 7th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326001777 NPPES
Michigan Other PROVIDER CODE 22 ATHLETIC TRAINER

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