Individual
KAY ELLEN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.PH.
Contact information
Practice address
1005 E 13 MILE RD, MADISON HTS, MI 48071-1533
(248) 307-4933
(248) 307-4965
Mailing address
4735 BENTLEY DR, TROY, MI 48098-4447
(248) 885-8678
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
5302027100
MI
Other
Enumeration date
05/07/2014
Last updated
05/07/2014
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