Individual
JIAYI CHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6071 W OUTER DR, DETROIT, MI 48235-2624
(313) 966-3350
Mailing address
1778 HARTSHORN AVE, TROY, MI 48083-1750
(248) 434-7743
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501004924
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5501004924
BUREAU OF PROFESSIONAL LICENSING
MI
Enumeration date
06/08/2018
Last updated
06/08/2018
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