| On Hold | |
|
205 N East Ave Jackson MI 49201-1753 | |
| (517) 788-4800 | |
| Not Available |
| Full Name | On Hold |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 205 N East Ave, Jackson, Michigan |
| Authorized Official Name and Position | Jeanne' Wickens (SENIOR VICE PRESIDENT OF FINANCE) |
| Authorized Official Contact | 5177886979 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| On Hold Po Box 67000 Department 272801 Detroit MI 48267-2728 Ph: (517) 841-6913 | On Hold 205 N East Ave Jackson MI 49201-1753 Ph: (517) 788-4800 |
| NPI Number | 1457563223 |
|---|---|
| Provider Enumeration Date | 05/04/2007 |
| Last Update Date | 05/14/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457563223 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (Michigan) | Primary |
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