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Individual
JESSE LOU
Active
Individual
JESSE LOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
MT227637
PA
208100000X
Physical Medicine & Rehabilitation Physician
4351044760
MI
208100000X
Physical Medicine & Rehabilitation Physician
Primary
D0100095
MD
Other
Enumeration date
06/06/2019
Last updated
04/18/2024
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