Healthcare Provider Details

I. General information

NPI: 1275118218
Provider Name (Legal Business Name): JEREMY MICHAEL FRANCOIS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2021
Last Update Date: 03/11/2021
Certification Date: 03/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2830 CORUNNA RD
FLINT MI
48503-3254
US

IV. Provider business mailing address

10191 TORREY RD
FENTON MI
48430-9794
US

V. Phone/Fax

Practice location:
  • Phone: 810-235-6812
  • Fax:
Mailing address:
  • Phone: 810-877-1981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: