Most Relevant Information
Provider Data
| NPI Number: | 1003035973 |
| Provider Name: | MELISSA J JACKSON RPH |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 5302027971 |
Most Important Dates
| Enumeration Date: | 04/25/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
1509 N MCEWAN ST
CLARE
MI
486171113
Practice Location Phone/Fax
| Phone: | 9893867721 |
| Fax: | 9893864505 |
Provider Mailing Location
1108 HEMLOCK ST
CLARE
MI
486171156
Provider Mailing Phone/Fax
| Phone: | 9893862317 |
| Fax: | 9893864505 |