Individual
MRS. JACKIE ANNE HARASEWICZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OMT
Contact information
Practice address
213 N PAW PAW ST, COLOMA, MI 49038-9589
(269) 753-8213
Mailing address
504 LOST OAK LN, WATERVLIET, MI 49098-8345
(269) 753-8213
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
2902016477
MI
174400000X
Specialist
Primary
—
—
Other
Enumeration date
02/20/2020
Last updated
02/24/2021
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