Individual
JENNIFER YELIZAROV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
15855 19 MILE RD, CLINTON TWP, MI 48038-3504
(586) 263-2300
Mailing address
712 S ALEXANDER AVE, ROYAL OAK, MI 48067-2875
(248) 470-1021
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601008271
MI
363A00000X
Physician Assistant
—
—
Other
Enumeration date
07/14/2017
Last updated
03/16/2021
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