Individual
EVAN ALEXANDER JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1970 E TROY ST, FERNDALE, MI 48220-2070
(248) 259-8313
Mailing address
1970 E TROY ST, FERNDALE, MI 48220-2070
(248) 259-8313
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
J525238044670
MI
Other
Enumeration date
03/10/2021
Last updated
03/10/2021
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