Individual
CHASITY L FALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
205 N EAST AVE, JACKSON, MI 49201-1753
(517) 788-4811
Mailing address
969 OLD PLANK RD, MILFORD, MI 48381-2940
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601005413
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5601005413
MI STATE MEDICAL LICENSE
MI
Enumeration date
09/26/2008
Last updated
09/26/2008
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