Provider Demographics
NPI:1154391670
Name:SPOELMAN, THOMAS G (RPH)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:G
Last Name:SPOELMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18936 PINEY POINT DR
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:49456-9229
Mailing Address - Country:US
Mailing Address - Phone:616-847-5004
Mailing Address - Fax:
Practice Address - Street 1:1116 ROBBINS RD
Practice Address - Street 2:
Practice Address - City:GRAND HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49417-2740
Practice Address - Country:US
Practice Address - Phone:616-846-7180
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302410978183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist