Individual
MICHAEL DALEN JAUREQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
159 HILLTOP CIR, BRIGHTON, TN 38011-6628
(901) 569-8012
Mailing address
159 HILLTOP CIR, BRIGHTON, TN 38011-6628
(901) 569-8012
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
—
—
372600000X
Adult Companion
Primary
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
12/06/2012
Last updated
06/25/2013
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