Individual
MR. JEROME CHIA DJAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11600 INTERLACHEN RD, CHISAGO CITY, MN 55013-7311
(651) 558-1454
Mailing address
11600 INTERLACHEN RD, CHISAGO CITY, MN 55013-7311
(651) 558-1454
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
1050106-2-AFC
MN
Other
Enumeration date
07/15/2009
Last updated
07/15/2009
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