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1902281645
ALLEN JACKSON
GRAND RAPIDS, MI
NPI
1902281645
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
251E00000X Home Health
(Licence: MI J250051155983)
Enumeration Date
2015-07-23
Last Update Date
2015-07-23
Business Address
-- ALLEN JACKSON
GENERAL DELIVERY
GRAND RAPIDS, MI 49501-9999
Phone number: 616-954-5095
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Mailing Address
-- ALLEN JACKSON
GENERAL DELIVERY
GRAND RAPIDS, MI 49501-9999
Phone number: 616-954-5095
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