Individual
JIMMY JONES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
17916 BONSTELLE AVE, SOUTHFIELD, MI 48075-3478
(313) 629-6800
Mailing address
17916 BONSTELLE AVE, SOUTHFIELD, MI 48075-3478
(313) 629-6800
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
J520414178589
MI
Other
Enumeration date
07/08/2012
Last updated
07/08/2012
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