Individual
JOANNE MARIE ICKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
434 W NORTH ST, JACKSON, MI 49202-3313
(517) 787-3250
Mailing address
725 CAPE COD, SOUTH LYON, MI 48178-1346
(248) 345-6784
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
MI
Other
Enumeration date
09/04/2018
Last updated
09/04/2018
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