Individual
JEREN WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4201 SAINT ANTOINE ST, DETROIT, MI 48201-2153
(313) 993-2530
Mailing address
4201 SAINT ANTOINE ST, DETROIT, MI 48201-2153
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/12/2017
Last updated
12/17/2021
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