Individual
KYLE JUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5295 TIMBERCREST TRL, JACKSON, MI 49201-9729
(517) 740-0004
Mailing address
5295 TIMBERCREST TRL, JACKSON, MI 49201-9729
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
05/07/2015
Last updated
05/07/2015
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