Individual
CYNTHIA M JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13745 19 MILE, STERLING HTS, MI 48313
(586) 247-1178
Mailing address
16016 BERRY LN, MACOMB, MI 48044-5631
(586) 247-1178
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501007031
MI
Other
Enumeration date
03/22/2007
Last updated
02/05/2008
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