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NPI 1740671627

NPI 1740671627 : MS. JENNIFER JO HUBBELL : HILLSDALE, MI

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General NPI Number Information
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    NPI Number           |    1740671627
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    Entity Type          |    Individual 
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    Provider Name        |    MS. JENNIFER JO HUBBELL
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/12/2015
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    Last Update Date     |    02/12/2015
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Provider Practice Location Address
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    Address Line         |    97 S BROAD ST 
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    City                 |    HILLSDALE
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    State                |    MI
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    Zip                  |    49242-2082
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    Country              |    US
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    Telephone            |    517-437-0057
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    11590 S JACKSON RD 
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    City                 |    CEMENT CITY
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    State                |    MI
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    Zip                  |    49233-9525
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    Country              |    US
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    Telephone            |    517-320-5164
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225700000X
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    Taxonomy Name        |    Massage Therapist
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    License Number       |    7501004941
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    License Number State |    MI
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