Individual
JUKKA OLAVI PIETILA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
4085 BURTON ST SE STE 100, GRAND RAPIDS, MI 49546-2444
(616) 233-3599
Mailing address
61 COMMERCE AVE SW, GRAND RAPIDS, MI 49503-4124
(616) 940-0660
(616) 940-1965
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501006211
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
650D115990
BCBSM
MI
Enumeration date
06/16/2006
Last updated
01/21/2025
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