Individual
JAKIA MICHELLE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2925 BRETON RD SE, GRAND RAPIDS, MI 49512-1745
(616) 243-4336
(616) 243-4423
Mailing address
2925 BRETON RD SE, GRAND RAPIDS, MI 49512-1745
(616) 243-4336
(616) 243-4423
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
06/15/2023
Last updated
06/15/2023
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