Organization
JUPITER WELLNESS CO LLC
Active
Organization
JUPITER WELLNESS CO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MALLARY JACKSON LMT (LMT)
(313) 699-5301
Entity
Organization
Contact information
Practice address
18218 JAMES COUZENS FWY, DETROIT, MI 48235-2501
(313) 699-5301
Mailing address
41470 E ARCHWOOD DR APT 134, VAN BUREN TOWNSHIP, MI 48111-4525
(313) 699-5301
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
12/09/2025
Last updated
12/09/2025
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