Individual
JACOB ALLEN LYTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2770 E BELTLINE AVE NE, GRAND RAPIDS, MI 49525-8614
(616) 267-8860
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
5101025074
MI
Other
Enumeration date
04/24/2017
Last updated
11/05/2024
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