Individual
MADELINE PATRICIA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNIM
Contact information
Practice address
43754 BRANDYWYNE RD, CANTON, MI 48187-2242
(586) 817-0671
Mailing address
550 N CENTRAL EXPY UNIT 2586, MCKINNEY, TX 75070-0139
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
—
—
Other
Enumeration date
08/16/2024
Last updated
09/08/2024
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