Organization
PROVIDER SERVICES NETWORK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMMAD K JAURA (OWNER)
(248) 225-4492
Entity
Organization
Contact information
Practice address
31500 W 13 MILE RD STE 106, FARMINGTON HILLS, MI 48334-2172
(248) 220-0600
(248) 579-9096
Mailing address
31500 W 13 MILE RD STE 106, FARMINGTON HILLS, MI 48334-2172
(248) 220-0600
(248) 579-9096
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
4301080436
MI
Other
Enumeration date
06/12/2017
Last updated
07/21/2022
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