Provider Demographics
NPI:1518098029
Name:HENSCH, TIM G (CPHT)
Entity Type:Individual
Prefix:
First Name:TIM
Middle Name:G
Last Name:HENSCH
Suffix:
Gender:M
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:719 KENSINGTON SQ
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:WI
Mailing Address - Zip Code:53589-4839
Mailing Address - Country:US
Mailing Address - Phone:608-541-8902
Mailing Address - Fax:608-873-4009
Practice Address - Street 1:160 BUSINESS PARK CIR
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:WI
Practice Address - Zip Code:53589-3392
Practice Address - Country:US
Practice Address - Phone:608-541-8902
Practice Address - Fax:608-873-4009
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI2301-0102-0750-210183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician