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1346454808
JOSEPH THOMAS MINICH
GREAT LAKES, IL
NPI
1346454808
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date
2007-05-10
Last Update Date
2007-07-08
Business Address
Mr. JOSEPH THOMAS MINICH other
2410 SAMPSON ST BLDG 237
GREAT LAKES, IL 60088-2942
Phone number: 847-688-2469
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Mailing Address
Mr. JOSEPH THOMAS MINICH other
9517 69TH ST
KENOSHA, WI 53142-8114
Phone number: 708-280-7356
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