Individual
MARC JETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
34557 ASH ST, WAYNE, MI 48184-1303
(734) 306-8995
Mailing address
34557 ASH ST, WAYNE, MI 48184-1303
(734) 306-8995
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704296390
MI
Other
Enumeration date
03/07/2016
Last updated
03/07/2016
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