NPI 1114550928

Jared Parks

Practitioner Driver Whitmore Lake, MI

Practice location

Address: 10 Jennings Rd, Whitmore Lake, MI 48189-9410
Phone: (734) 449-0110

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X

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Registry record

NPI: 1114550928
Entity type: Individual
Sex (as registered): Male
NPI issued: 20 Feb 2020
Record last updated: 20 Feb 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.