Individual
FERNANDO JOSE RIVAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
700 WILDWOOD AVE, JACKSON, MI 49201-1017
(517) 962-4815
Mailing address
700 WILDWOOD AVE, JACKSON, MI 49201-1017
(517) 962-4815
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
6803088963
MI
Other
Enumeration date
05/06/2026
Last updated
05/06/2026
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