Individual
JASON HARRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
20266 BRADFORD ST, DETROIT, MI 48205-1005
(313) 918-8491
Mailing address
20266 BRADFORD ST, DETROIT, MI 48205-1005
(313) 918-8491
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
11/04/2016
Last updated
11/04/2016
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