| NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
| 1669830162 | INGALLS | MICHELLE | 205 N EAST AVE | JACKSON | MI | 492011753 | ||
| 1780912667 | LEE | BENJAMIN | J | 205 N EAST AVE | JACKSON | MI | 492011753 | |
| 1720316763 | VAN TASSELL | COURTNEY | 205 N EAST AVE | JACKSON | MI | 492011753 |