Search › Michigan › 101YA0400X
Jackie Moore, MA
NPI 1629355870 · on the registry since 2011 · sole proprietor
Practice
- Address
- 18530 Mack Ave Ste 101
Grosse Pointe, MI 48236 - Phone
- (313) 673-9073
- Fax
- (313) 884-8442
- Organisation at this address
- Assisted Care Transportation Inc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 101YA0400X
101YA0400X
- Also registered as
- 103TC1900X
- Licence states on file
- MI
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2011-11-15
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan