Individual
JORVON BRISON SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
18400 MONTE VISTA ST, DETROIT, MI 48221-1951
(424) 333-0073
Mailing address
18400 MONTE VISTA ST, DETROIT, MI 48221-1951
(424) 333-0073
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
5785155
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5785155
—
MI
Enumeration date
10/21/2024
Last updated
10/21/2024
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