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Individual

JACOB KAINE YATES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
47601 GRAND RIVER AVE, NOVI, MI 48374-1233
(248) 465-4100
Mailing address
10487 RUNYAN LAKE PT, FENTON, MI 48430-2499

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
MI

Other

Enumeration date
02/28/2018
Last updated
02/28/2018
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