Leja Jackson Inc

NPI 1235209099 - Family Medicine - 207Q00000X

NPI Details
NPI 1235209099
Enumeration Date 11/09/2006
Last Updated 05/06/2013
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name LORETTA M LORETTA
Position OWNER
Phone (231) 597-8192
Fax (231) 597-8463
Practice Location
920 S HURON ST
CHEBOYGAN MI, 49721-2267, US
Phone (231) 597-8192
Fax (231) 597-8463
Business Location
920 S HURON ST
CHEBOYGAN MI, 49721-2267, US
Phone (231) 597-8192
Fax (231) 597-8463
Toxanomy
Taxonomy Code 207Q00000X
License State Michigan
License Number 4301042693
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According to our database, Leja Jackson Inc NPI is 1235209099, taxonomy code is 207Q00000X and license number is 4301042693, license state is located at Michigan. Leja Jackson Inc physically located at 920 S Huron St, Cheboygan MI, 49721-2267. NPI Number 1033115704 has the healthcare provider type.

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1235209099 NPI number is provided on an as is basis without warranty of any kind. 1235209099 is maintained by the National Plan & Provider Enumeration System. The contents of Leja Jackson Inc are for informational purposes only.