Provider Demographics
NPI:1083610778
Name:LUNDY, DANIELLE WOODS (DPT)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:WOODS
Last Name:LUNDY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6016 W MAPLE RD
Mailing Address - Street 2:STE 705
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-4411
Mailing Address - Country:US
Mailing Address - Phone:248-862-2551
Mailing Address - Fax:248-757-8053
Practice Address - Street 1:6016 W MAPLE RD STE 705
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-4411
Practice Address - Country:US
Practice Address - Phone:248-862-2551
Practice Address - Fax:248-757-8053
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501017767225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist