JOHN T JACKSON

DETROIT, MI
NPI1407986037
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2007-03-06
Last Update Date2007-07-08
Business Address
-- JOHN T JACKSON CAC-1
13575 LESURE ST
DETROIT, MI 48227-3131
Phone number: 313-493-4410
Mailing Address
-- JOHN T JACKSON CAC-1
13575 LESURE ST
DETROIT, MI 48227-3131
Phone number: 313-493-4410
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