Individual
DR. JENNIFER SUPOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
31500 TELEGRAPH RD, 105, BINGHAM FARMS, MI 48025-4367
(248) 540-8700
(248) 540-8701
Mailing address
31500 TELEGRAPH RD, 105, BINGHAM FARMS, MI 48025-4367
(248) 540-8700
(248) 540-8701
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
5101014945
MI
Other
Enumeration date
08/09/2006
Last updated
07/08/2007
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