Individual
PHILLIP WAYNE JEWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
16300 WOODWARD AVE, HIGHLAND PARK, MI 48203-2882
(313) 365-7211
(313) 365-7211
Mailing address
21840 HARDING ST, OAK PARK, MI 48237-2523
(313) 365-7211
(313) 365-7211
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
MI
Other
Enumeration date
08/05/2019
Last updated
08/05/2019
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