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1679693436
WAYNE JOLLY
DETROIT, MI
NPI
1679693436
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MI 5601001710)
Enumeration Date
2007-03-29
Last Update Date
2016-10-25
Business Address
-- WAYNE JOLLY PA-C
4100 JOHN R ST KARMANOS CANCER CENTER
DETROIT, MI 48201-2013
Phone number: 800-527-6266
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Mailing Address
-- WAYNE JOLLY PA-C
1560 E MAPLE RD SUITE 400-CREDENTIALING
TROY, MI 48083-1138
Phone number: 800-527-6266
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