Individual
JONATHAN G DECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
46961 VANDYKE AVE, SHEBY TOWNSHIP, MI 48317
(586) 991-5205
Mailing address
6626 HALLOWAY LN, LANSING, MI 48917-9290
(313) 590-8188
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601008727
MI
Other
Enumeration date
07/09/2018
Last updated
07/09/2018
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