Individual
JOHN JACQUART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
27177 LAHSER RD, SUITE 203, SOUTHFIELD, MI 48034-8416
(248) 357-4151
(248) 357-0229
Mailing address
1420 STEPHENSON HWY, SUITE 400-CREDENTIALING, TROY, MI 48083-1189
(248) 581-5974
(248) 581-5640
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
1601000413
MI
Other
Enumeration date
07/03/2006
Last updated
01/03/2014
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