Individual
JACKSON SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
29121 NORTHWESTERN HWY STE A, SOUTHFIELD, MI 48034-5705
(248) 599-1166
Mailing address
1773 STAR BATT DR, ROCHESTER HILLS, MI 48309-3708
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501302079
MI
Other
Enumeration date
02/14/2023
Last updated
02/14/2023
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