Individual
JACOB VAN PELT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2415 5TH AVE S, ESCANABA, MI 49829-1201
(906) 786-6907
Mailing address
106 PROVIDER ST, GWINN, MI 49841-2726
(906) 458-0015
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502005850
MI
Other
Enumeration date
05/20/2021
Last updated
05/20/2021
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