Individual
DONITA DARLENE JARDINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2550 MEADOWBROOK RD, BENTON HARBOR, MI 49022-9609
Mailing address
2550 MEADOWBROOK RD, BENTON HARBOR, MI 49022-9609
(269) 985-4400
(269) 985-4444
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501003990
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912094525
—
MI
Enumeration date
03/29/2018
Last updated
06/16/2018
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