Individual
JONATHAN GLENN DELACRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
B.S PT
Contact information
Practice address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-1000
Mailing address
1801 CRESTVIEW DR, CANTON, MI 48188-2044
(734) 722-7083
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501004334
MI
Other
Enumeration date
08/03/2006
Last updated
07/08/2007
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