# PROVIDER SERVICES NETWORK LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407385529
- **Authorized official:** MOHAMMAD K JAURA (OWNER)
- **Authorized official phone:** (248) 225-4492

## Contact information

- **Practice address:** 31500 W 13 MILE RD STE 106, FARMINGTON HILLS, MI 48334-2172
- **Practice address phone:** (248) 220-0600
- **Practice address fax:** (248) 579-9096
- **Mailing address:** 31500 W 13 MILE RD STE 106, FARMINGTON HILLS, MI 48334-2172
- **Mailing address phone:** (248) 220-0600
- **Mailing address fax:** (248) 579-9096

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208VP0000X | Pain Medicine Physician | 4301080436 | MI | Yes |

## Other

- **Enumeration date:** 06/12/2017
- **Last updated:** 07/21/2022