Individual
JESSE FANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
3520 GREEN CT STE 1200, ANN ARBOR, MI 48105-1595
(734) 239-8110
(734) 239-8111
Mailing address
33900 HARPER AVE STE 104, CLINTON TOWNSHIP, MI 48035-4258
(586) 350-2644
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501303069
MI
Other
Enumeration date
03/28/2024
Last updated
03/31/2026
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