Individual
JACLYN L MASCARIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1221 PINE GROVE AVE, PORT HURON, MI 48060-3511
(810) 989-3300
Mailing address
PO BOX 595498, FORT GRATIOT, MI 48059-5498
(810) 300-4887
(810) 985-2671
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601011637
MI
363A00000X
Physician Assistant
PA9107043
FL
Other
Enumeration date
04/09/2013
Last updated
05/04/2023
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