Most Relevant Information
Provider Data
| NPI Number: | 1003044611 |
| Provider Name: | SAMANTHA RENE DANEK PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | 5601005511 |
Most Important Dates
| Enumeration Date: | 06/23/2009 |
| Last Updated: | 10/13/2016 |
Provider Practice Location
205 N EAST AVE
JACKSON
MI
492011753
Practice Location Phone/Fax
| Phone: | 5177884811 |
| Fax: |
Provider Mailing Location
PO BOX 67000
DEPT 272801
DETROIT
MI
482672728
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |