Individual
JACQUELINE MAXEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2850 S INDURSTRIAL HWY, SUITE 75, ANN ARBOR, MI 48104
(734) 477-7204
Mailing address
2850 S INDURSTRIAL HWY, SUITE 75, ANN ARBOR, MI 48104
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703031564
MI
Other
Enumeration date
10/26/2010
Last updated
10/26/2010
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