JEREMIAH BACALSO DUCUSIN

CLINTON TOWNSHIP, MI
NPI1164173001
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
Enumeration Date2022-01-12
Last Update Date2022-01-12
Business Address
JEREMIAH BACALSO DUCUSIN PA-C
15855 19 MILE RD
CLINTON TOWNSHIP, MI 48038-3504
Phone number: 586-263-2300
Mailing Address
JEREMIAH BACALSO DUCUSIN PA-C
50083 MARGARET AVE
MACOMB, MI 48044-6340
Phone number: 586-412-0838