Individual
JONATHAN DELTON STAFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CHW
Contact information
Practice address
500 N JACKSON ST, JACKSON, MI 49201-1223
(517) 748-5500
Mailing address
2955 PHEASANT RUN DR, JACKSON, MI 49202-1344
(517) 885-5238
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
MI
Other
Enumeration date
10/03/2023
Last updated
10/03/2023
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