Individual
JENNY GILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
4071 24TH AVE, FORT GRATIOT, MI 48059-3801
(810) 824-4222
(810) 824-4220
Mailing address
1206 WASHINGTON AVE, PORT HURON, MI 48060-3555
(810) 985-6778
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601003727
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457497471
—
MI
Enumeration date
01/29/2007
Last updated
09/21/2020
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