Individual
JAYLEN PARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11340 PORTLANCE ST, DETROIT, MI 48205-5204
(313) 412-6703
Mailing address
11340 PORTLANCE ST, DETROIT, MI 48205-5204
(313) 412-6703
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
01/06/2025
Last updated
01/06/2025
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