Provider Demographics
NPI:1407632359
Name:TUSCH, GREGORY ALAN
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:ALAN
Last Name:TUSCH
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 1:8028 THERESE CT SE
Mailing Address - Street 2:
Mailing Address - City:CALEDONIA
Mailing Address - State:MI
Mailing Address - Zip Code:49316-8972
Mailing Address - Country:US
Mailing Address - Phone:616-719-6794
Mailing Address - Fax:
Practice Address - Street 1:8028 THERESE CT SE
Practice Address - Street 2:
Practice Address - City:CALEDONIA
Practice Address - State:MI
Practice Address - Zip Code:49316-8972
Practice Address - Country:US
Practice Address - Phone:616-719-6794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach