Individual
JACOB BRUCE GIDEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6051 FRANKFORT HWY STE 200, BENZONIA, MI 49616-9651
(231) 655-3146
Mailing address
6051 FRANKFORT HWY STE 200, BENZONIA, MI 49616-9651
(231) 655-3146
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/30/2024
Last updated
11/04/2025
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