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1124149786
JERRY D MOSES
SOUTHGATE, MI
NPI
1124149786
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
(Licence: MI 6802073537)
Enumeration Date
2007-04-02
Last Update Date
2007-07-08
Business Address
-- JERRY D MOSES bs
13101 ALLEN RD
SOUTHGATE, MI 48195-2216
Phone number: 734-785-7705
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Mailing Address
-- JERRY D MOSES bs
13101 ALLEN RD
SOUTHGATE, MI 48195-2216
Phone number: 734-785-7705
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