Individual
TABITA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11160 WJ PRESLEY PKWY STE 102, ALLENDALE, MI 49401-8075
(616) 384-2810
Mailing address
2550 RANDALL AVE NW, WALKER, MI 49534-7541
(616) 633-4997
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
3500104616
MI
Other
Enumeration date
01/03/2007
Last updated
04/29/2024
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