Individual
MELONIE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
26640 BELANGER ST, ROSEVILLE, MI 48066-3185
(580) 278-2307
Mailing address
26640 BELANGER ST, ROSEVILLE, MI 48066-3185
(580) 278-2307
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
11/16/2016
Last updated
11/16/2016
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