Individual
BRANTLEY SCOTT JEZAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
9315 TELEGRAPH RD, REDFORD, MI 48239-1260
(313) 450-4500
Mailing address
8883 MELVIN ST, LIVONIA, MI 48150-3917
(248) 505-4293
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704305907
MI
Other
Enumeration date
10/08/2024
Last updated
10/08/2024
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