Individual provider · Type 1 NPI

Thomas Blackport

Student in an Organized Health Care Education/Training Program · Holland, MI

NPI number 1942673314 Active

Practice location

222 Fairbanks Ave
Holland, MI 49423-3735

Call (616) 395-7070 Map

Specialties and licenses

TaxonomyCodeLicense
Athletic Trainer 2255A2300XNone listed
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1942673314

Thomas Blackport's National Provider Identifier is 1942673314, issued on Nov 7, 2015. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Holland, MI. The record was last updated on Nov 7, 2015.