Individual
TANA JACKOSN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1903 W MICHIGAN AVE, KALAMAZOO, MI 49008-5200
(269) 387-3248
Mailing address
1903 W MICHIGAN AVE, KALAMAZOO, MI 49008-5200
(269) 387-3248
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502003072
—
Other
Enumeration date
08/26/2021
Last updated
08/26/2021
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