Individual
MICHELLE ANN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7124 DIVING PETRELS PL, 7124 DIVING PETRELS PL, NORTH LAS VEGAS, NV 89084-2353
(702) 772-0768
Mailing address
7124 DIVING PETRELS PL, 7124 DIVING PETRELS PL, NORTH LAS VEGAS, NV 89084-2353
(702) 772-0768
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
03/31/2011
Last updated
03/31/2011
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