Provider Demographics
NPI:1386178697
Name:KJAM HEALTH SERVICES, PC
Entity Type:Organization
Organization Name:KJAM HEALTH SERVICES, PC
Other - Org Name:MICHIGAN WEIGHTLOSS, PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CURTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-940-8848
Mailing Address - Street 1:5050 MARSH RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-1158
Mailing Address - Country:US
Mailing Address - Phone:517-940-8848
Mailing Address - Fax:
Practice Address - Street 1:5050 MARSH RD
Practice Address - Street 2:SUITE 5
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-1158
Practice Address - Country:US
Practice Address - Phone:517-940-8848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-13
Last Update Date:2018-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI86029170133V00000X
MI2013008347363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty