Provider Demographics
NPI:1093988776
Name:WELCH, DANIEL J (MPT)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:J
Last Name:WELCH
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:878 S ROCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-2740
Mailing Address - Country:US
Mailing Address - Phone:248-601-9207
Mailing Address - Fax:
Practice Address - Street 1:21550 HARRINGTON ST
Practice Address - Street 2:SUITE D
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48036-2362
Practice Address - Country:US
Practice Address - Phone:586-783-7590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501013769225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist