Individual
CHERYL BELLANCA JACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
812 E JOLLY RD, STE G12, LANSING, MI 48910-6818
(517) 346-8283
(517) 346-8291
Mailing address
812 E JOLLY RD, STE 210, LANSING, MI 48910-6818
(517) 346-8410
(517) 346-8291
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
4301062157
MI
Other
Enumeration date
06/22/2006
Last updated
07/09/2007
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