Individual
BRIAN KEITH PUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
396 DITMAR AVE, PONTIAC, MI 48341-2614
(248) 238-9328
Mailing address
396 DITMAR AVE, PONTIAC, MI 48341-2614
(248) 238-9328
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
10/14/2021
Last updated
10/14/2021
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