Individual
JEFF VAILU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
28880 APPLEBLOSSOM DRIVE, FLAT ROCK, MI 48134-3151
(734) 642-5932
Mailing address
28880 APPLE BLOOSM DRIVE, FLAT ROCK, MI 48134-3151
(734) 782-5932
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703108476
MI
Other
Enumeration date
07/18/2016
Last updated
04/06/2017
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