SearchMichiganDietary Manager

Jorge Prada, CNS

NPI 1588089684 · on the registry since 2014 · sole proprietor

Practice

Address
5885 S Main St
Suite 6b
Clarkston, MI 48346
Phone
(248) 707-6367
Fax
(248) 707-6233
Organisation at this address
Moonbeam Massage Llc
Jennifer Caudill, Md Pllc
Cynthia L Cookingham Md Pc
Main Street Dermatology, Pllc
Michael E. Stachecki, M.D., P.L.L.C.
Inferred from a shared address, not stated in the registry.
Clinicians at this address
7

Registry record

Primary taxonomy
Dietary Manager
132700000X
Licence states on file
IL
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2014-02-26

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan