NPI 1679872014

Belle Jackson

Practitioner Mechanotherapist Fenton, MI

Practice location

Address: 2815 W Silver Lake Rd, Fenton, MI 48430-2655
Phone: (810) 629-4575
Mailing address: 8390 Tipsico Trl, Holly, MI 48442-8108

Registered specialties

Mechanotherapist Primary

Other Service Providers Taxonomy 172M00000X

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Registry record

NPI: 1679872014
Entity type: Individual
Sex (as registered): Female
NPI issued: 24 Mar 2011
Record last updated: 24 Mar 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.