Blackport, Thomas

Blackport, Thomas is an individual health care provider with primary practice located at 222 Fairbanks Ave , Holland MI 49423-3735. He recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, Student, Health Care / Student in an Organized Health Care Education/Training Program. Student, Health Care / Student in an Organized Health Care Education/Training Program is his primary health care specialty. Blackport, Thomas can be contacted via phone (616) 395-7070.

Contact Information

Primary practice address
222 Fairbanks Ave Holland MI 49423-3735
Phone: (616) 395-7070
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1942673314
LBN Legal business name Blackport, Thomas
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 7th, 2015
Last updated Nov 7th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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