Individual
JOSEPH JIJO JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
900 COOK RD, GROSSE POINTE WOODS, MI 48236-2739
(313) 885-5005
Mailing address
19622 JEROME ST APT 185, ROSEVILLE, MI 48066-1245
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501013101
MI
Other
Enumeration date
03/21/2018
Last updated
03/21/2018
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