Individual
KYRA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMA
Contact information
Practice address
14261 FENTON, REDFORD, MI 48239-2878
(313) 970-3572
Mailing address
14261 FENTON, REDFORD, MI 48239-2878
(313) 970-3572
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
05/18/2023
Last updated
05/18/2023
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