Individual
MS. JODY WELLWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-1340
(313) 916-7139
Mailing address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-1340
(313) 916-7139
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704169894
MI
Other
Enumeration date
05/23/2007
Last updated
07/08/2007
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