| Jacob Matthew Mattia, DPT | |
| 
					395 N Groesbeck Hwy Ste L, Mount Clemens, MI 48043-1561  | |
| (586) 630-0474 | |
| (586) 630-0476 | 
| Full Name | Jacob Matthew Mattia | 
|---|---|
| Gender | Male | 
| Speciality | Physical Therapist | 
| Location | 395 N Groesbeck Hwy Ste L, Mount Clemens, Michigan | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1447999529 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 225100000X | Physical Therapist | 5501302104 (Michigan) | Primary | 
| Provider Name | Advanced Health Alliance Llc | 
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice | 
| Provider Identifiers | NPI Number: 1467904615 PECOS PAC ID: 2860776648 Enrollment ID: O20170222000989  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Jacob Matthew Mattia, DPT 54313 Scarboro Way, Shelby Township, MI 48316-1287 Ph: (248) 321-7249  | Jacob Matthew Mattia, DPT 395 N Groesbeck Hwy Ste L, Mount Clemens, MI 48043-1561 Ph: (586) 630-0474  | 
Surekha Samel,  Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1000 Harrington St, Mount Clemens, MI 48043 Phone: 586-493-8000  | |
Michelle Lewinski, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1000 Harrington St, Mount Clemens, MI 48043 Phone: 586-493-8000  | |
Shabbir Hussain,  Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 198 S Main St Ste 1, Mount Clemens, MI 48043 Phone: 586-477-1402  | |
Elizabath Shabu,  Physical Therapist Medicare: Medicare Enrolled Practice Location: 243 Cass Ave Ste A, Mount Clemens, MI 48043 Phone: 586-783-7590  | |
Gary Lutes, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1000 Harrington St, Mount Clemens, MI 48043 Phone: 586-493-8000  | |
Mr. Jose Luis C. Escudero, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1000 Harrington St, Mount Clemens, MI 48043 Phone: 586-493-2044  | |
Heather Piper, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1000 Harrington St, Mount Clemens, MI 48043 Phone: 586-493-8000  |