Individual
JACOB RYAN CHASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
801 W BIG BEAVER RD STE 300, TROY, MI 48084-4725
(815) 409-1772
Mailing address
15617 CABRILLO WAY, BEE CAVE, TX 78738-6187
(815) 409-1772
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
052512
NY
225100000X
Physical Therapist
Primary
1290979
TX
225100000X
Physical Therapist
5501303407
MI
225100000X
Physical Therapist
CP033169T
IA
225100000X
Physical Therapist
CP033184T
WI
225100000X
Physical Therapist
PT032657
PA
Other
Enumeration date
06/27/2017
Last updated
08/10/2024
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