Individual
JACKIE LYNN HUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8333 FELCH ST, ZEELAND, MI 49464-2608
(616) 772-5793
Mailing address
8333 FELCH ST, ZEELAND, MI 49464-2608
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
5201001619
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5201001619
—
MI
Enumeration date
03/19/2018
Last updated
06/16/2018
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