Individual
JACOB MATTHEW MATTIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
395 N GROESBECK HWY STE L, MOUNT CLEMENS, MI 48043-1561
(586) 630-0474
(586) 630-0476
Mailing address
54313 SCARBORO WAY, SHELBY TOWNSHIP, MI 48316-1287
(248) 321-7249
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501302104
MI
Other
Enumeration date
05/27/2022
Last updated
05/27/2022
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