Individual
JEFF ENSROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
555 SAINT CLAIR RIVER DR, ALGONAC, MI 48001-1802
(810) 794-4982
(810) 794-4407
Mailing address
555 SAINT CLAIR RIVER DR, ALGONAC, MI 48001-1802
(810) 794-4982
(810) 794-4407
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401008717
MI
Other
Enumeration date
09/15/2006
Last updated
07/08/2007
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