Search › Michigan › 174400000X
Keely Jackson, CERTIFIED
NPI 1396044269 · on the registry since 2011
Practice
- Address
- 21268 Venice Dr
Macomb, MI 48044 - Phone
- (586) 948-8954
- Fax
- (586) 948-8954
Registry record
- Primary taxonomy
- 174400000X
174400000X
- Licence states on file
- CO
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2011-03-17
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan