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Individual

SHANTESE JONES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
19194 EDGEFIELD ST, GROSSE POINTE, MI 48236-2020
(313) 695-8387
Mailing address
19194 EDGEFIELD ST, GROSSE POINTE, MI 48236-2020
(313) 695-8387

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703111312
MI

Other

Enumeration date
05/23/2016
Last updated
05/23/2016
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