Individual
JACOB ANDREW DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
304 GLEN CARIN DR NE, ROCKFORD, MI 49341-9395
(616) 481-1357
Mailing address
304 GLEN CARIN DR NE, ROCKFORD, MI 49341-9395
(616) 481-1357
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
04/06/2017
Last updated
04/06/2017
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