Male or Other

Michael A. Jenks CPO

Full Name

Michael A Jenks CPO

NPI Number

1336269513

NPI Type

Individual Provider

Gender

Male

Enumeration Date

03/30/2007

Specialties

(Taxonomies)

Code

222Z00000X
224P00000X

Primary Taxonomy

No
No

Contact
Information

Purpose

Mailing
Location

Address

2034 RANDOLPH RD
2034 RANDOLPH RD

City

Charlotte
Charlotte

State

NC
NC

Postal Code

28207-1216
28207-1216

Country

US
US

Telephone Number

(704) 377-7099
(704) 377-7099

Identifiers

Identifier

7703499
7795013

Identifier State

NC
NC

Identifier Issuer

Unknown
Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 07/09/2007

Provider Address