Individual
MR. JACOB PUTHENPARAMPIL JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
2215 FULLER RD, 111 (I), ANN ARBOR, MI 48105-2303
(734) 845-5393
Mailing address
8361 CHATHAM DR, CANTON, MI 48187-4447
Taxonomy
Speciality
Code
Description
License number
State
163WI0600X
Infection Control Registered Nurse
Primary
4704245304
MI
Other
Enumeration date
03/09/2012
Last updated
01/28/2013
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