Individual
MALLARY JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
18218 JAMES COUZENS FWY, DETROIT, MI 48235-2501
(313) 699-5301
Mailing address
41470 E ARCHWOOD DR APT A134, VAN BUREN TOWNSHIP, MI 48111-4501
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
75010016559
MI
Other
Enumeration date
12/01/2025
Last updated
12/01/2025
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