Individual
JODI L MCCOLLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
420 W MAGNETIC ST, SUITE ER, MARQUETTE, MI 49855-2711
(906) 225-4854
(906) 225-3370
Mailing address
420 W MAGNETIC ST, SUITE ER, MARQUETTE, MI 49855-2711
(906) 225-4854
(906) 225-3370
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601003915
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5601003915
MICHIGAN LICENSE
MI
Enumeration date
01/12/2007
Last updated
07/09/2007
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