| Organization Name: | MOBILE MEDICAL CONSULTANT PLLC |
| NPI Number: | 1023130853 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JENNIE ANN BROOKS (PHYSICIAN ASSISTANT) |
| Mailing Address: | 620 S Dorchester Ave Royal Oak |
| State: | MI US |
| Postal Code: | 480674048 |
| Phone Number: | 2482108883 |
| Fax Number: | |
| NPI Enumeration Date: | 04/04/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 5601003725 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |