Provider Demographics
NPI:1215119649
Name:DONBERG, JILL MARIE (MACOM, DIPL OM)
Entity type:Individual
Prefix:MS
First Name:JILL
Middle Name:MARIE
Last Name:DONBERG
Suffix:
Gender:F
Credentials:MACOM, DIPL OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:626 E 8TH ST
Mailing Address - Street 2:SUITE #17
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-2504
Mailing Address - Country:US
Mailing Address - Phone:231-929-8183
Mailing Address - Fax:231-929-8185
Practice Address - Street 1:626 E 8TH ST
Practice Address - Street 2:SUITE #17
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-2504
Practice Address - Country:US
Practice Address - Phone:231-929-8183
Practice Address - Fax:231-929-8185
Is Sole Proprietor?:No
Enumeration Date:2007-11-27
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist