Individual
JAIMIE LEE COULOMBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
35 MICHIGAN ST NE # 4128, GRAND RAPIDS, MI 49503-2514
(616) 267-2727
Mailing address
3052 CREEK WAY CT SE, KENTWOOD, MI 49512-9163
(760) 985-0417
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
5501018246
MI
225100000X
Physical Therapist
PT39626
CA
2251P0200X
Pediatric Physical Therapist
Primary
PT 39626
CA
Other
Enumeration date
01/29/2013
Last updated
03/17/2018
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