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1164173001
JEREMIAH BACALSO DUCUSIN
CLINTON TOWNSHIP, MI
NPI
1164173001
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant Medical
Enumeration Date
2022-01-12
Last Update Date
2022-01-12
Business Address
JEREMIAH BACALSO DUCUSIN PA-C
15855 19 MILE RD
CLINTON TOWNSHIP, MI 48038-3504
Phone number: 586-263-2300
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Mailing Address
JEREMIAH BACALSO DUCUSIN PA-C
50083 MARGARET AVE
MACOMB, MI 48044-6340
Phone number: 586-412-0838
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