Individual
JAKE PAUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
20873 MACK AVE, GROSSE POINTE WOODS, MI 48236-1313
(313) 466-7884
(313) 464-0001
Mailing address
2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501304403
MI
225100000X
Physical Therapist
Primary
—
MI
Other
Enumeration date
02/02/2026
Last updated
05/07/2026
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