Individual
MR. DUANE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3111 GRAND RIVER AVE, DETROIT, MI 48208-2962
(313) 964-3900
Mailing address
29511 STEINHAUER ST, INKSTER, MI 48141-3418
(734) 620-0475
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
11/01/2023
Last updated
11/01/2023
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