MEDICARE: ALESA JAMISON

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
1	146N00000X	Basic Emergency Medical Technician		MI

General Provider Information

NPI Number	:	1457018244
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALESA JAMISON

Provider Business Mailing Address
First Line	:	2869 TROY CENTER DR APT 3025
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48084-4720
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2626 S ADAMS RD STE 9
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48309-5509
Country	:	US
Telephone Number	:	248-678-7406
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2021
Last Update Date	:	11/29/2021

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Directions to “ ALESA JAMISON ” Practice Location

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