Individual
JESSICA JO GRACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4154 S RIVER RD BLDG 2, EAST CHINA, MI 48054-2930
(810) 329-6710
(810) 329-8790
Mailing address
4154 S RIVER RD BLDG 2, EAST CHINA, MI 48054-2930
(810) 329-6710
(810) 329-8790
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301082242
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1952490765
—
MI
01
—
4301082242
PHYSICIAN LICENSE
MI
Enumeration date
10/11/2006
Last updated
05/06/2019
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