Individual
JAYLEN GERARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15333 CHEYENNE ST, DETROIT, MI 48227-3607
(313) 293-9581
Mailing address
15333 CHEYENNE ST, DETROIT, MI 48227-3607
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
10/16/2015
Last updated
10/16/2015
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