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1306009196
JACK D WOODBURN
PORT HURON, MI
NPI
1306009196
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: MI 6401000326)
Enumeration Date
2008-07-02
Last Update Date
2008-07-02
Business Address
Mr. JACK D WOODBURN LPC
1101 MILITARY ST
PORT HURON, MI 48060-5418
Phone number: 810-984-5575
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Mailing Address
Mr. JACK D WOODBURN LPC
1101 MILITARY ST
PORT HURON, MI 48060-5418
Phone number: 810-984-5575
Copy
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