Individual
JACKIE SI'DELAVET BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2512 FOX LN, FLINT, MI 48507-2090
(772) 563-3877
Mailing address
2512 FOX LN, FLINT, MI 48507-2090
(772) 563-3877
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
—
Other
Enumeration date
05/04/2023
Last updated
05/04/2023
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