Belle Jackson
Mechanotherapist in Fenton, MI. Individual provider (NPI-1).
NPI number1679872014
StatusActive
Last updated in NPPESMar 24, 2011
Details
- NPI
- 1679872014
- Entity type
- Individual (NPI-1)
- Name
- Belle Jackson
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 24, 2011
- Last updated
- Mar 24, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 172M00000X | Mechanotherapist | – | MI | Yes |
Other names
- Belle Jackson (Professional Name)
Practice location
2815 W Silver Lake RdFenton, MI 48430-2655
Phone 810-629-4575
Mailing address
8390 Tipsico TrlHolly, MI 48442-8108
Phone 810-629-4575
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