Individual
ANNIE JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
705 S MAIN ST, STE. 220, PLYMOUTH, MI 48170-2089
(734) 354-8000
Mailing address
705 S MAIN ST, STE. 220, PLYMOUTH, MI 48170-2089
(734) 354-8000
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501011891
MI
Other
Enumeration date
04/15/2011
Last updated
04/15/2011
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