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1679056873
JACOB ALAN BROKENSHAW
CLARKSTON, MI
NPI
1679056873
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: MI 5501018904)
Enumeration Date
2018-09-13
Last Update Date
2018-09-13
Business Address
JACOB ALAN BROKENSHAW DPT
32 S MAIN ST
CLARKSTON, MI 48346-1526
Phone number: 248-922-9001
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Mailing Address
JACOB ALAN BROKENSHAW DPT
1773 STAR BATT DR
ROCHESTER HILLS, MI 48309-3708
Phone number: 248-601-9207
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