Individual
SPENCER JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
6333 KALAMAZOO AVE SE STE 600, GRAND RAPIDS, MI 49508-7858
(616) 649-1577
(616) 710-3019
Mailing address
2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
(630) 575-6200
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201013949
MI
Other
Enumeration date
11/23/2021
Last updated
10/03/2025
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