Individual
DR. JACK EDISON CRIBB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3618 BENTON RD, CHARLOTTE, MI 48813-7756
(517) 652-1059
Mailing address
3618 BENTON RD, CHARLOTTE, MI 48813-7756
(517) 652-1059
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
1769156
MI
Other
Enumeration date
05/15/2007
Last updated
07/08/2007
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