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NPI Code Detail

MEDICARE: MJO DERMAL RESCUE INC

MEDICARE: MJO DERMAL RESCUE INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WW0000XWound Care Registered Nurse

General Provider Information

NPI Number : 1013274844
Entity Type Code : Organization
Provider Name (Legal Business Name) : MJO DERMAL RESCUE INC
Provider Business Mailing Address
First Line : 4181 WINDMILL FARMS
Second Line :
City : MILFORD
State : MI
Zip : 48380-4279
Country : US
Telephone Number : 248-804-4323
Fax Number :
Provider Business Practice Location Address
First Line : 4181 WINDMILL FARMS
Second Line :
City : MILFORD
State : MI
Zip : 48380-4279
Country : US
Telephone Number : 248-804-4323
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MRS. MARY JO OLDFORD
Credential : N.P.
Telephone Number : 248-804-4323
Provider Enumeration Date : 04/18/2012
Last Update Date : 04/18/2012

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Directions to “MJO DERMAL RESCUE INC ” Practice Location

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