Most Relevant Information
Provider Data
| NPI Number: | 1003668203 |
| Provider Name: | TAMIKA JACKSON |
| Entity Type: | Individual |
| Taxonomy Code: | 251E00000X |
| Specialty: | Home Health |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/02/2024 |
| Last Updated: | 04/02/2024 |
Provider Practice Location
24123 GREENFIELD RD # 311207
SOUTHFIELD
MI
480753125
Practice Location Phone/Fax
| Phone: | 3134574114 |
| Fax: |
Provider Mailing Location
24123 GREENFIELD RD STE 311
SOUTHFIELD
MI
480753124
Provider Mailing Phone/Fax
| Phone: | 3134574114 |
| Fax: |