MEDICARE: JACOB HOLT PT, DPT, AT, ATC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center	5501302468	MI
2	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1497448187
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACOB HOLT PT, DPT, AT, ATC

Provider Business Mailing Address
First Line	:	1002 W BROOMFIELD ST APT 8C
Second Line	:
City	:	MOUNT PLEASANT
State	:	MI
Zip	:	48858-4530
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1232 GRISWOLD ST SE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49507-3815
Country	:	US
Telephone Number	:	616-207-3861
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2023
Last Update Date	:	04/28/2025

Similar Medicare Providers

1104006626 — JENNIFER WOLFFIS PT
Practice Location Address:

1232 GRISWOLD ST SE
GRAND RAPIDS, MI
49507-3815

Practice Phone: 616-207-3861
Practice Fax: 616-327-6364

1487024212 — LIFE THERAPEUTIC SOLUTIONS, INC
Practice Location Address:

1208 GRISWOLD ST SE
GRAND RAPIDS, MI
49507-3815

Practice Phone: 616-828-5492
Practice Fax: 855-207-3270

1265005151 — HOME CONNECTION THERAPY LLC
Practice Location Address:

1232 GRISWOLD ST SE
GRAND RAPIDS, MI
49507-3815

Practice Phone: 616-890-8660
Practice Fax:

1376210484 — MRS. KYLYN L LYNCH PT, DPT
Practice Location Address:

1232 GRISWOLD ST SE
GRAND RAPIDS, MI
49507-3815

Practice Phone: 616-207-3861
Practice Fax: 616-327-6364

1801665476 — HARMONY HORIZON SERVICES LLC
Practice Location Address:

828 C AVE NW
CEDAR RAPIDS, IA
52405-3815

Practice Phone: 319-440-4641
Practice Fax:

1699103820 — MCPHERSON PEST CONTROL
Practice Location Address:

7979A SHADY GROVE ROAD
GRAND RIDGE, FL
32442-3815

Practice Phone: 850-593-5674
Practice Fax: 850-593-0583

Directions to “ JACOB HOLT PT, DPT, AT, ATC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.