Individual
JEFFREY NICHOLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
22515 S KANE ST, DETROIT, MI 48223-2571
(248) 631-8048
Mailing address
22515 S KANE ST, DETROIT, MI 48223-2571
(248) 631-8048
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
MI
Other
Enumeration date
05/26/2015
Last updated
05/26/2015
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