Individual
BELLE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2815 W SILVER LAKE RD, FENTON, MI 48430-2655
(810) 629-4575
Mailing address
8390 TIPSICO TRL, HOLLY, MI 48442-8108
(810) 629-4575
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
—
MI
Other
Enumeration date
03/24/2011
Last updated
03/24/2011
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