Individual
RENA ADELL JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14881GREENFIELD RD, DETROIT, MI 48227
(313) 424-0048
Mailing address
14881GREENFIELD RD APT 1, DETROIT, MI 48227
(313) 424-0048
Taxonomy
Speciality
Code
Description
License number
State
175L00000X
Homeopath
Primary
8947370
MI
Other
Enumeration date
07/17/2015
Last updated
07/17/2015
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