Provider Demographics
NPI:1467613026
Name:CRANBROOK ALLERGY ASTHMA AND SINUS CARE PLLC
Entity Type:Organization
Organization Name:CRANBROOK ALLERGY ASTHMA AND SINUS CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:L
Authorized Official - Last Name:JOLIAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-267-5008
Mailing Address - Street 1:4600 INVESTMENT DR
Mailing Address - Street 2:STE 110
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-6365
Mailing Address - Country:US
Mailing Address - Phone:248-267-5008
Mailing Address - Fax:248-530-9848
Practice Address - Street 1:4600 INVESTMENT DR
Practice Address - Street 2:STE 110
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48098-6365
Practice Address - Country:US
Practice Address - Phone:248-267-5008
Practice Address - Fax:248-530-9848
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty