Individual
MR. JOHN JOSEPH COFFEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CAS/CADC
Contact information
Practice address
19211 ANGLIN ST, DETROIT, MI 48234-1460
(313) 263-0077
Mailing address
19211 ANGLIN ST, DETROIT, MI 48234-1460
(313) 263-0077
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/21/2021
Last updated
06/21/2021
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