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Individual

JACOB SHIELDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
8741 W SAGINAW HWY, LANSING, MI 48917-7752
(517) 925-8825
(517) 990-6212
Mailing address
3073 SHIRLEY DR, JACKSON, MI 49201-7010
(517) 990-6210
(517) 990-6212

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501020040
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C80776
BCBS
MI
Enumeration date
05/28/2021
Last updated
02/10/2025
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