Individual
SARITA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
294 E BOSTON BLVD, DETROIT, MI 48202-1321
(313) 610-4034
Mailing address
294 E BOSTON BLVD, DETROIT, MI 48202-1321
(313) 610-4034
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
07/15/2016
Last updated
07/15/2016
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