PAYTON JACKSON

DETROIT, MI
NPI1609316777
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy251S00000X Community/Behavioral Health
(Licence: MI  251S00000X)
Enumeration Date2017-03-08
Last Update Date2017-03-08
Business Address
-- PAYTON JACKSON
445 LEDYARD ST
DETROIT, MI 48201-2641
Phone number: 313-962-9446
Mailing Address
-- PAYTON JACKSON
445 LEDYARD ST
DETROIT, MI 48201-2641
Phone number: 313-964-9446
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