Basic Information
| Provider Information | |||||||||
| NPI: | 1538491295 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARTON | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | BRUCE | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | RN, EMT-B | ||||||||
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| Mailing Information | |||||||||
| Address1: | 104 S MAPLE ST | ||||||||
| Address2: | |||||||||
| City: | ONSTED | ||||||||
| State: | MI | ||||||||
| PostalCode: | 492659634 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5174677802 | ||||||||
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| Practice Location | |||||||||
| Address1: | 205 N EAST AVE | ||||||||
| Address2: | |||||||||
| City: | JACKSON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 492011753 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5177884811 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/05/2010 | ||||||||
| LastUpdateDate: | 02/05/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 146N00000X | 3203042050 | MI | N | Emergency Medical Service Providers | Emergency Medical Technician, Basic | 163WE0003X | 4704259547 | MI | Y | Nursing Service Providers | Registered Nurse | Emergency |
No ID Information.