Individual
JACOB EDWARD MOENCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
44201 DEQUINDRE RD, TROY, MI 48085-1117
(248) 964-4866
(248) 585-4848
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
(248) 585-8266
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/29/2017
Last updated
07/29/2022
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