Individual
KARLY BAISDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
205 N EAST AVE, JACKSON, MI 49201-1753
(517) 841-1328
(517) 841-1330
Mailing address
PO BOX 67000, DEPARTMENT 272801, DETROIT, MI 48267-2728
(517) 841-1328
(517) 841-1330
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601006863
MI
Other
Enumeration date
12/17/2013
Last updated
12/17/2013
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