Individual
TERESA WACKUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
3300 LANSING AVE, JACKSON, MI 49202-1621
(517) 784-2929
(517) 784-3030
Mailing address
3300 LANSING AVE, JACKSON, MI 49202-1621
(517) 784-2929
(517) 784-3030
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
12/10/2013
Last updated
12/10/2013
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