Individual
JACOB CHACKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
261 W CANFORD PARK, CANTON, MI 48187-6667
(248) 935-3364
(734) 983-0575
Mailing address
261 W CANFORD PARK, CANTON, MI 48187-6667
(248) 935-3364
(734) 983-0575
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501009281
MI
Other
Enumeration date
02/01/2008
Last updated
02/01/2008
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