Individual
JACOB BURCICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
39575 W 10 MILE RD STE 201, NOVI, MI 48375-2949
(248) 516-7250
(248) 516-7251
Mailing address
33900 HARPER AVE STE 104, CLINTON TWP, MI 48035-4258
(586) 350-2644
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501302451
MI
Other
Enumeration date
01/06/2023
Last updated
01/06/2023
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