Individual
KEJUAN DESHAWN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7401 PARKLAND, REDFORD, MI 48239-1015
(313) 914-2117
Mailing address
17583 HARTWELL ST, DETROIT, MI 48235-2639
(313) 286-6790
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
10/04/2019
Last updated
10/04/2019
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