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1255180535
JACK JEFFERY DEGRACE
BRIDGEPORT, MI
NPI
1255180535
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2024-05-17
Last Update Date
2024-05-17
Business Address
JACK JEFFERY DEGRACE
6296 BRIDGEPORT VILLAGE SQUARE DR STE 2
BRIDGEPORT, MI 48722-9655
Phone number: 989-401-1239
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Mailing Address
JACK JEFFERY DEGRACE
5039 VILLA LINDE PKWY STE 30
FLINT, MI 48532-3450
Phone number: 989-401-2244
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