Theresa Jackson

NPI #1104207083 in River Rouge, Michigan

Provider Information

NPI Number
1104207083
Entity Type
Individual
Name
Theresa Jackson
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Chore Provider
Enumeration Date
Jun 16, 2015
Last Updated
Jun 16, 2015

Practice Location

Address
77 E GREAT LAKES ST APT 303
ZIP Code
48218-1584
Phone
(313) 208-4140

Specialties & Taxonomy Codes

Specialty
Chore Provider

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