Individual
DR. JENNIFER MANKO PROHOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1455 S LAPEER RD, SUITE 100, LAKE ORION, MI 48360-1467
(248) 693-3551
(248) 693-4643
Mailing address
3099 BROOKSIDE DR, WATERFORD, MI 48328-2595
(248) 681-5890
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101015830
MI
Other
Enumeration date
02/27/2007
Last updated
07/08/2007
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