Provider Demographics
NPI:1821315938
Name:HECHTMAN, JOEL YALE (BS)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:YALE
Last Name:HECHTMAN
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6455 US HIGHWAY 31 N
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:MI
Mailing Address - Zip Code:49690-9306
Mailing Address - Country:US
Mailing Address - Phone:231-938-1181
Mailing Address - Fax:231-938-0093
Practice Address - Street 1:6455 US HIGHWAY 31 N
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:MI
Practice Address - Zip Code:49690-9306
Practice Address - Country:US
Practice Address - Phone:231-938-1181
Practice Address - Fax:231-938-0093
Is Sole Proprietor?:No
Enumeration Date:2010-04-28
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302020356183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist