Daniels, Michael John

Daniels, Michael John is an individual health care provider with primary practice located at 1065 W Broadway Ave , Medford WI 54451-1311. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Daniels, Michael John can be contacted via phone (715) 748-2316.

Contact Information

Primary practice address
1065 W Broadway Ave Medford WI 54451-1311
Phone: (715) 748-2316
Fax: (715) 748-2570
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 9578-024 Wisconsin

Profile Details

NPI number 1780867499
LBN Legal business name Daniels, Michael John
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 17th, 2007
Last updated Dec 17th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780867499 NPPES
Wisconsin MEDICAID 40397600

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