Individual
JASMIN GILLOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1416 6TH ST APT 1, PORT HURON, MI 48060-5982
(313) 690-5055
Mailing address
28459 HOLLYWOOD ST, ROSEVILLE, MI 48066-2599
(313) 690-5055
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
03/21/2024
Last updated
03/21/2024
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