Individual
JESSICA C ANKLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1375 N MAIN ST, ATTN NUTRITIONAL SERVICES, LAPEER, MI 48446-1350
(810) 667-5712
(810) 667-5856
Mailing address
1375 N MAIN ST, ATTN NUTRITIONAL SERVICES, LAPEER, MI 48446-1350
(810) 667-5712
(810) 667-5856
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
949603
IL
Other
Enumeration date
08/09/2006
Last updated
07/08/2007
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