Individual
JORDAN MALIK LAWAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
261 MACK AVE, DETROIT, MI 48201-2417
(313) 745-9793
Mailing address
18540 JEANETTE ST, SOUTHFIELD, MI 48075-1727
(517) 803-1398
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501019020
MI
Other
Enumeration date
03/06/2019
Last updated
03/06/2019
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