Organization
GA VISITING PROVIDERS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOLENE KASSAB FNP (PART-OWNER)
(248) 763-8266
Entity
Organization
Contact information
Practice address
3212 WINCHESTER RD, WEST BLOOMFIELD, MI 48322-2420
(248) 763-8266
Mailing address
3212 WINCHESTER RD, WEST BLOOMFIELD, MI 48322-2420
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
05/10/2023
Last updated
05/10/2023
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