Individual
JODI LYNNE DEJAEGHERE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
36485 GARFIELD RD, CLINTON TOWNSHIP, MI 48035-1132
(586) 791-0738
(586) 791-3240
Mailing address
26120 CULVER ST, SAINT CLAIR SHORES, MI 48081-3330
(248) 860-6127
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
5303008702
MI
Other
Enumeration date
06/28/2021
Last updated
06/28/2021
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