Individual
TERRENCE EDWARD JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPRM
Contact information
Practice address
15941 FAIRFIELD ST, DETROIT, MI 48238-4123
(313) 345-4310
(313) 345-4315
Mailing address
15941 FAIRFIELD ST, DETROIT, MI 48238-4123
(313) 345-4310
(313) 345-4315
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
SA0823212
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204986314
—
MI
Enumeration date
11/20/2017
Last updated
11/20/2017
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