Individual
BETHANY SUZANNE BROOKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
400 HINCKLEY BLVD STE 100, JACKSON, MI 49203-6152
(517) 205-2149
Mailing address
400 HINCKLEY BLVD STE 100, JACKSON, MI 49203-6152
(517) 205-2149
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601010477
MI
Other
Enumeration date
09/08/2021
Last updated
06/07/2023
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