Healthcare Provider Details

I. General information

NPI: 1255097184
Provider Name (Legal Business Name): SPRINGCREST SLEEP SOLUTIONS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2021
Last Update Date: 11/15/2021
Certification Date: 11/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2424 SPRING ARBOR RD
JACKSON MI
49203-2748
US

IV. Provider business mailing address

2424 SPRING ARBOR RD
JACKSON MI
49203-2748
US

V. Phone/Fax

Practice location:
  • Phone: 517-787-2226
  • Fax:
Mailing address:
  • Phone: 517-787-2226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. ELIZABETH JEAN RUTLEDGE
Title or Position: OWNER/PRESIDENT
Credential: DDS
Phone: 517-787-2226