Organization
RONALD J FLACK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA ETUE (BILLER)
(517) 522-8582
Entity
Organization
Contact information
Practice address
762 W MICHIGAN AVE, JACKSON, MI 49201-1978
(517) 782-8142
(517) 782-0765
Mailing address
762 W MICHIGAN AVE, JACKSON, MI 49201-1978
(517) 782-8142
(517) 782-0765
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704149271
MI
Other
Enumeration date
08/17/2012
Last updated
08/17/2012
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