Individual
AIDEN XIAOLOU CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1200 N WEST AVE, JACKSON, MI 49202-2179
(800) 284-8288
Mailing address
21203 W M 60, HOMER, MI 49245-8604
(503) 509-8628
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
101260015
MI
Other
Enumeration date
04/22/2024
Last updated
04/22/2024
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