Latoya Jackson PA-C

NPI 1144340902 - Physician Assistant - 363A00000X

NPI Details
NPI 1144340902
Gender Female
Enumeration Date 03/29/2007
Last Updated 05/14/2013
Entity Type Individual
Active Over 9 years ago
Practice Location
6071 W OUTER DR
DETROIT MI, 48235-2624, US
Phone (313) 966-3300
Fax
Business Location
6071 W OUTER DR SGR
DETROIT MI, 48235, US
Phone (313) 966-3300
Fax
Toxanomy
Taxonomy Code 363A00000X
License State Michigan
License Number 5601004292
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According to our database, Mrs. Latoya Jackson PA-C NPI is 1144340902, taxonomy code is 363A00000X and license number is 5601004292, license state is located at Michigan. Latoya Jackson PA-C physically located at 6071 W Outer Dr, Detroit MI, 48235-2624. NPI Number Latoya Jackson PA-C has the Individual type.

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1144340902 NPI number is provided on an as is basis without warranty of any kind. 1144340902 is maintained by the National Plan & Provider Enumeration System. The contents of Latoya Jackson PA-C are for informational purposes only.