Individual
EMILY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1100 W SAGINAW ST STE 2A, LANSING, MI 48915-2033
(517) 321-4646
(517) 321-4825
Mailing address
1100 W SAGINAW ST STE 2A, LANSING, MI 48915-2033
(517) 321-4646
(517) 321-4825
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501012247
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30658
BCBS
MI
Enumeration date
10/02/2006
Last updated
01/27/2022
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