IMMANUEL JACKSON

WYOMING, MI
NPI1598452864
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2023-04-18
Last Update Date2023-04-18
Business Address
IMMANUEL JACKSON DO
5900 BYRON CENTER AVE SW
WYOMING, MI 49519-9606
Phone number: 616-252-7200
Mailing Address
IMMANUEL JACKSON DO
5900 BYRON CENTER AVE SW
WYOMING, MI 49519-9606
Phone number: 616-252-7200
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