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1417622408
JERRY DOUGLAS LICKFELT
PORT HURON, MI
NPI
1417622408
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
175T00000X Peer Specialist
Enumeration Date
2021-08-11
Last Update Date
2021-08-11
Business Address
JERRY DOUGLAS LICKFELT CPSS
3111 ELECTRIC AVE
PORT HURON, MI 48060-8127
Phone number: 810-966-8900
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Mailing Address
JERRY DOUGLAS LICKFELT CPSS
3111 ELECTRIC AVE
PORT HURON, MI 48060-8127
Phone number:
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