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Individual

JAQUAN DEVONN THURMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
8643 GREENVIEW AVE, DETROIT, MI 48228-3149
(734) 338-5871
Mailing address
44526 BAYVIEW AVE APT 14212, CLINTON TOWNSHIP, MI 48038-7066

Taxonomy

Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary

Other

Enumeration date
07/24/2023
Last updated
07/24/2023
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