Individual
JASMINE POLK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20056 IRVINGTON STREET, DETROIT, MI 48203
(313) 955-1416
Mailing address
20056 IRVINGTON STREET, DETROIT, MI 48203
(313) 955-1416
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8129980
—
MI
Enumeration date
10/21/2021
Last updated
10/21/2021
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