Provider Demographics
NPI:1477788388
Name:THULIN, PAUL ALLEN (MBA-HIS)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:ALLEN
Last Name:THULIN
Suffix:
Gender:M
Credentials:MBA-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10800 NORMANDALE BLVD
Mailing Address - Street 2:SUITE 103M
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55437-3130
Mailing Address - Country:US
Mailing Address - Phone:952-225-1604
Mailing Address - Fax:952-241-9202
Practice Address - Street 1:10800 NORMANDALE BLVD
Practice Address - Street 2:SUITE 103M
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55437-3130
Practice Address - Country:US
Practice Address - Phone:952-225-1604
Practice Address - Fax:952-241-9202
Is Sole Proprietor?:No
Enumeration Date:2009-05-20
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2665237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist