Provider Demographics
NPI:1235547092
Name:NAWROT, THOMAS
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:NAWROT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17575 US 223
Mailing Address - Street 2:SUITE B
Mailing Address - City:CEMENT CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49233
Mailing Address - Country:US
Mailing Address - Phone:517-547-6863
Mailing Address - Fax:
Practice Address - Street 1:17575 US 223
Practice Address - Street 2:SUITE A
Practice Address - City:CEMENT CITY
Practice Address - State:MI
Practice Address - Zip Code:49233
Practice Address - Country:US
Practice Address - Phone:517-547-6863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-24
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3501005102237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist