Individual
JASMINE DEIDRA BATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7381 WARWICK ST, DETROIT, MI 48228-4500
(313) 404-0196
Mailing address
7381 WARWICK ST, DETROIT, MI 48228-4500
(313) 404-0196
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
06/24/2015
Last updated
06/24/2015
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