Organization
CRESCENTOX, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN JACKSON (OWNER)
(248) 259-1510
Entity
Organization
Contact information
Practice address
16250 NORTHLAND DR, SUITE 135, SOUTHFIELD, MI 48075
(248) 259-1510
(248) 809-9151
Mailing address
16250 NORTHLAND DR, SUITE 135, SOUTHFIELD, MI 48075
(248) 259-1510
(248) 809-9151
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
05/18/2015
Last updated
11/18/2016
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