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Organization

HEALTH FULL ELEMENTS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAWN JAKUBOWSKI MT (OWNER; MANAGER)
(586) 216-0990
Entity
Organization

Contact information

Practice address
11443 E 13 MILE RD, 404, WARREN, MI 48093-2589
(586) 216-0990
Mailing address
25797 CURIE AVE, WARREN, MI 48091-3829
(586) 216-0990

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
7501004559
MI

Other

Enumeration date
08/05/2015
Last updated
08/05/2015
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