Individual
JENNIFER JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1300 BEARD ST, PORT HURON, MI 48060-6562
(810) 982-9500
Mailing address
52496 FOX POINTE DR, NEW BALTIMORE, MI 48047-6365
(586) 822-4134
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501012127
MI
Other
Enumeration date
03/26/2018
Last updated
03/26/2018
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