Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156F00000X | Technician/Technologist |
NPI | 1245825272 |
---|---|
Provider Name | Al Dujuan Jones JR. |
First Address | Sterling Heights, MI 48312-6392 |
Second Address | Sterling Heights, MI 48312-6392 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2021 |
Last Update Date | 02/03/2021 |